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AD/PD 2023 | Safety results of the Phase III gantenerumab GRADUATE I and II studies

Stephen P. Salloway, MD, MS, Butler Hospital & Warren Alpert Medical School of Brown University, Providence, RI, presents the safety outcomes of the gantenerumab Phase III GRADUATE I (NCT03444870) and II (NCT03443973) studies. The GRADUATE I and II studies assessed the safety and efficacy of subcutaneous gantenerumab in patients with early, symptomatic Alzheimer’s Disease (AD), but did not show a benefit on the rate of cognitive decline over 27 months, compared to placebo. Safety results showed that amyloid related imaging abnormalities (ARIA) were common, but mostly asymptomatic. ARIA-E and ARIA-H occurred at rates of 25% and 23%, respectively. The most common safety outcomes identified were infusion reactions. This interview took place at the AD/PD™ 2023 congress in Gothenburg, Sweden.

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Transcript (edited for clarity)

The main focus of my presentation at AD/PD was on safety outcomes with gantenerumab and the GRADUATE program. And basically, it showed that there was ARIA, sort of at predicted rates that we’ve seen in other trials and that the pattern of the ARIA was similar to what we’ve seen as well. So typically asymptomatic and transient, and manageable in the clinical trial setting. There were no deaths that were clearly related to ARIA or to treatment with gantenerumab...

The main focus of my presentation at AD/PD was on safety outcomes with gantenerumab and the GRADUATE program. And basically, it showed that there was ARIA, sort of at predicted rates that we’ve seen in other trials and that the pattern of the ARIA was similar to what we’ve seen as well. So typically asymptomatic and transient, and manageable in the clinical trial setting. There were no deaths that were clearly related to ARIA or to treatment with gantenerumab. So overall it looked like the medication was well tolerated or at least as expected given this class of amyloid lowering antibodies. There were some infusion reactions or site injection reactions which again we had seen in prior trials as well. So no major new safety concerns.

Now unfortunately, the main focus of the trial, the primary outcome was on the clinical outcome and although there was some numerical benefits for gantenerumab in both GRADUATE I and GRADUATE II, it didn’t really reach significance. And I think the company has decided not to take this version of gantenerumab forward based on that.

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