Anton P. Porsteinsson, MD

“In my book, what’s happening with the other humanized monoclonal antibodies that target fibrillary and, to some degree, soluble beta-amyloid—that’s a very intriguing story. It goes beyond aducanumab.”

Last year, the field of Alzheimer disease (AD) underwent a massive change, headlined by the FDA approval of the first therapy for the disease since 2003: aducanumab (Aduhelm; Biogen). Although, despite the controversial conversations happening around the approval of the antiamyloid monoclonal antibody, far more was happening in the background.

For Anton Porsteinsson, MD, director, Alzheimer's Disease Care, Research and Education Program; William B. and Sheila Konar Professor of Psychiatry, School of Medicine and Dentistry, University of Rochester, the bustling activity of the pipeline is a sign of health for the field. In a conversation with 

®, he highlighted some of the progress that has been made by additional antiamyloid-ß antibodies in the pipeline and offered his insight into how their advancement will lend a better idea of the effectiveness of the overall class of medicines.

Porsteinsson focused on the 3 main players that are making their way through phase 3 trials—namely 

 (Roche)—and provided context on the current understanding of their effect on AD and the structure of their clinical trials. All 3 agents have been fast tracked for review by the FDA, and a few of them are expected to attempt the same route of accelerated approval that aducanumab did.

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The director of the Alzheimer's Disease Care, Research and Education Program at the University of Rochester offered an extensive overview of 3 monoclonal antibodies in development for Alzheimer disease. [WATCH TIME: 9 minutes]

Monoclonal Antibodies in Development for Alzheimer Disease: Anton Porsteinsson, MD

"We’re also using that study to understand more the impact of a simple, straightforward, psychosocial intervention on people with agitation."

Anton P. Porsteinsson, MD, the Director of the University of Rochester Alzheimer's Disease Care, Research and Education Program, sat with NeurologyLive to discuss the currently ongoing s-CitAD Study, which is exploring s-citalopram in patients with Alzheimer who also have symptoms of agitation.

The study, uniquely, is seeking to determine the answers to several questions, including the obvious—identifying if s-citalopram is beneficial in patients with agitation and Alzheimer, who are the patients that are more likely to respond to s-citalopram versus placebo&mdash;but also the not-so-obvious&mdash;who are the patients that are going to respond to a non-pharmacological intervention? Porsteinssen noted that he and the investigator hope to find out the degree of improvement with a non-pharmacological intervention that’s can actually be applied in clinical practice.

To do that, the investigators are utilizing a 3-week lead-in in which patients will be given a psychosocial intervention in patients with Alzheimer disease who have a moderate-to-severe form of agitation. The patients that improve on that alone will then be transferred to an observational cohort that will be followed for observation, while those that do not improve will be randomized to either s-citalopram or placebo for a 12-week double-blind period.

The Director of the University of Rochester Alzheimer's Disease Care, Research and Education Program discussed the ongoing study, which is exploring s-citalopram in patients with Alzheimer who also have symptoms of agitation.

Anton P. Porsteinsson, MD

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Monoclonal Antibodies in Development for Alzheimer Disease: Anton Porsteinsson, MD

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