TY - JOUR AU - Bateman, Randall J AU - Li, Yan AU - McDade, Eric M AU - Llibre-Guerra, Jorge J AU - Clifford, David B AU - Atri, Alireza AU - Mills, Susan L AU - Santacruz, Anna M AU - Wang, Guoqiao AU - Supnet, Charlene AU - Benzinger, Tammie L S AU - Gordon, Brian A AU - Ibanez, Laura AU - Klein, Gregory AU - Baudler, Monika AU - Doody, Rachelle S AU - Delmar, Paul AU - Kerchner, Geoffrey A AU - Bittner, Tobias AU - Wojtowicz, Jakub AU - Bonni, Azad AU - Fontoura, Paulo AU - Hofmann, Carsten AU - Kulic, Luka AU - Hassenstab, Jason AU - Aschenbrenner, Andrew J AU - Perrin, Richard J AU - Cruchaga, Carlos AU - Renton, Alan E AU - Xiong, Chengjie AU - Goate, Alison A AU - Morris, John C AU - Holtzman, David M AU - Snider, B Joy AU - Mummery, Catherine AU - Brooks, William S AU - Wallon, David AU - Berman, Sarah B AU - Roberson, Erik AU - Masters, Colin L AU - Galasko, Douglas R AU - Jayadev, Suman AU - Sanchez-Valle, Rachel AU - Pariente, Jeremie AU - Kinsella, Justin AU - van Dyck, Christopher H AU - Gauthier, Serge AU - Hsiung, Ging-Yuek Robin AU - Masellis, Mario AU - Dubois, Bruno AU - Honig, Lawrence S AU - Jack, Clifford R AU - Daniels, Alisha AU - Aguillón, David AU - Allegri, Ricardo AU - Chhatwal, Jasmeer AU - Day, Gregory AU - Fox, Nick C AU - Huey, Edward AU - Ikeuchi, Takeshi AU - Jucker, Mathias AU - Lee, Jae-Hong AU - Levey, Allan I AU - Levin, Johannes AU - Lopera, Francisco AU - Roh, JeeHoon AU - Rosa-Neto, Pedro AU - Schofield, Peter R TI - Safety and efficacy of long-term gantenerumab treatment in dominantly inherited Alzheimer's disease: an open-label extension of the phase 2/3 multicentre, randomised, double-blind, placebo-controlled platform DIAN-TU trial. JO - The lancet VL - 24 IS - 4 SN - 1474-4422 CY - London PB - Lancet Publ. Group M1 - DZNE-2025-00461 SP - 316 - 330 PY - 2025 AB - Amyloid plaque removal by monoclonal antibody therapies slows clinical progression in symptomatic Alzheimer's disease; however, the potential for delaying the onset of clinical symptoms in asymptomatic people is unknown. The Dominantly Inherited Alzheimer Network Trials Unit (DIAN-TU) is an ongoing platform trial assessing the safety and efficacy of multiple investigational products in participants with dominantly inherited Alzheimer's disease (DIAD). Based on findings of amyloid removal and downstream biological effects from the gantenerumab group of the platform trial, we continued a 3-year open-label extension (OLE) study to assess the safety and efficacy of long-term treatment with high doses of gantenerumab.The randomised, placebo-controlled, double-blind, phase 2/3 multi-arm trial (DIAN-TU-001) assessed solanezumab or gantenerumab versus placebo in participants who were between 15 years before and 10 years after their estimated years to symptom onset and who had a Clinical Dementia Rating (CDR) global score of 0 (cognitively normal) to 1 (mild dementia). This study was followed by an OLE study of gantenerumab treatment, conducted at 18 study sites in Australia, Canada, France, Ireland, Puerto Rico, Spain, the UK, and the USA. For inclusion in the OLE, participants at risk for DIAD had participated in the double-blind period of DIAN-TU-001 and were required to know their mutation status. We investigated increasing doses of subcutaneous gantenerumab up to 1500 mg every 2 weeks. Due to the lack of a regulatory path for gantenerumab, the study was stopped early after a prespecified interim analysis (when most participants had completed 2 years of treatment) of the clinical measure CDR-Sum of Boxes (CDR-SB). The primary outcome for the final analysis was the amyloid plaque measure 11C-Pittsburgh compound-B positron emission tomography (PiB-PET) standardised uptake value ratio (SUVR [PiB-PET SUVR]) at 3 years, assessed in the modified intention-to-treat group (mITT; defined as participants who received any gantenerumab treatment post-OLE baseline, had at least one PiB-PET SUVR assessment before gantenerumab treatment, and a post-baseline assessment). All participants who received at least one dose of study drug in the OLE were included in the safety analysis. DIAN-TU-001 (NCT01760005) and the OLE (NCT06424236) are registered with ClinicalTrials.gov.Of 74 participants who were recruited into the OLE study between June 3, 2020, and April 22, 2021, 73 were enrolled and received gantenerumab treatment. 47 (64 KW - Humans KW - Antibodies, Monoclonal, Humanized: therapeutic use KW - Antibodies, Monoclonal, Humanized: pharmacology KW - Antibodies, Monoclonal, Humanized: administration & dosage KW - Double-Blind Method KW - Male KW - Female KW - Alzheimer Disease: drug therapy KW - Alzheimer Disease: genetics KW - Middle Aged KW - Treatment Outcome KW - Adult KW - Aged KW - Antibodies, Monoclonal, Humanized (NLM Chemicals) KW - gantenerumab (NLM Chemicals) KW - solanezumab (NLM Chemicals) LB - PUB:(DE-HGF)16 C6 - pmid:40120616 DO - DOI:10.1016/S1474-4422(25)00024-9 UR - https://pub.dzne.de/record/277740 ER -