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Vol 58, No 2 (2024)
Invited Review Article
Submitted: 2023-06-30
Accepted: 2023-07-25
Published online: 2023-08-22
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Updates on pharmacological treatment for Alzheimer’s disease

Philip W. Tipton1
DOI: 10.5603/pjnns.96286
·
Pubmed: 37606550
·
Neurol Neurochir Pol 2024;58(2):150-160.
Affiliations
  1. Department of Neurology, Mayo Clinic, Jacksonville, Florida, United States

open access

Vol 58, No 2 (2024)
Invited review articles
Submitted: 2023-06-30
Accepted: 2023-07-25
Published online: 2023-08-22

Abstract

Alzheimer’s disease (AD) is the most common cause of dementia, and its rising prevalence is constantly increasing the global health burden. There are currently no curative therapies for AD, and current treatment options provide only modest clinical benefit. Despite numerous clinical trials, there have been no major additions to the AD treatment armamentarium this century. The prevailing pathomechanistic hypothesis for AD begins with abnormal accumulation of amyloid β (Aβ) leading to plaque development, and disease-modifying candidate therapies have largely aimed to disrupt this process. Numerous clinical trials of monoclonal antibodies directed at various stages of Aβ plaque development have yielded mostly negative results; however, recent results suggest that a breakthrough may be on the horizon. The past two years have yielded positive results for three monoclonal antibodies (aducanumab, lecanemab, and donanemab) although questions remain regarding their clinical effectiveness. Additional clarity is needed to determine whether the clinical benefits are great enough to offset the treatment risks and the resource implications for healthcare systems. This review provides a foundational context and update on recent disease-modifying therapies for AD that have reached Phase III clinical trials. Up-to-date information on these therapies will help clinicians better inform their clinical decision-making and the counselling they can offer patients and their carers.

Abstract

Alzheimer’s disease (AD) is the most common cause of dementia, and its rising prevalence is constantly increasing the global health burden. There are currently no curative therapies for AD, and current treatment options provide only modest clinical benefit. Despite numerous clinical trials, there have been no major additions to the AD treatment armamentarium this century. The prevailing pathomechanistic hypothesis for AD begins with abnormal accumulation of amyloid β (Aβ) leading to plaque development, and disease-modifying candidate therapies have largely aimed to disrupt this process. Numerous clinical trials of monoclonal antibodies directed at various stages of Aβ plaque development have yielded mostly negative results; however, recent results suggest that a breakthrough may be on the horizon. The past two years have yielded positive results for three monoclonal antibodies (aducanumab, lecanemab, and donanemab) although questions remain regarding their clinical effectiveness. Additional clarity is needed to determine whether the clinical benefits are great enough to offset the treatment risks and the resource implications for healthcare systems. This review provides a foundational context and update on recent disease-modifying therapies for AD that have reached Phase III clinical trials. Up-to-date information on these therapies will help clinicians better inform their clinical decision-making and the counselling they can offer patients and their carers.

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Keywords

dementia, Alzheimer’s disease, treatment, amyloid, clinical trials

About this article
Title

Updates on pharmacological treatment for Alzheimer’s disease

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 58, No 2 (2024)

Article type

Invited Review Article

Pages

150-160

Published online

2023-08-22

Page views

1168

Article views/downloads

1063

DOI

10.5603/pjnns.96286

Pubmed

37606550

Bibliographic record

Neurol Neurochir Pol 2024;58(2):150-160.

Keywords

dementia
Alzheimer’s disease
treatment
amyloid
clinical trials

Authors

Philip W. Tipton

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