Neuropsychological, neuropsychiatric, and quality‐of‐life assessments in Alzheimer's disease patients treated with plasma exchange with albumin replacement from the randomized AMBAR study

INTRODUCTION: We report the effects of plasma exchange (PE) with albumin replacement on neuropsychological, neuropsychiatric, and quality‐of‐life (QoL) outcomes in mild‐to‐moderate Alzheimer's disease (AD) patients in a phase 2b/3 trial (Alzheimer's Management by Albumin Replacement [AMBAR] study). METHODS: Three hundred forty‐seven patients were randomized into placebo (sham‐PE) and three PE‐treatment arms with low/high doses of albumin, with/without intravenous immunoglobulin (IVIG). Specific test measurements were performed at baseline; month 2 (weekly conventional PE); months 6, 9, and 12 (monthly low‐volume PE [LVPE]); and month 14. RESULTS: The PE‐treated mild‐AD cohort improved their language fluency and processing speed versus placebo at month 14 (effect sizes: >100%; P‐values: .03 to .001). The moderate‐AD cohort significantly improved short‐term verbal memory (effect sizes: 94% to >100%; P‐values: .02 to .003). The progression of the neuropsychiatric symptoms of PE‐treated was similar to placebo. Mild‐AD patients showed improved QoL (P‐values: .04 to .008). DISCUSSION: PE‐treated AD patients showed improvement in memory, language abilities, processing speed, and QoL‐AD. No worsening of their psychoaffective status was observed.