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Review
. 2023 Sep 9;24(18):13900.
doi: 10.3390/ijms241813900.

Treatment of Alzheimer's Disease: Beyond Symptomatic Therapies

Francesca R Buccellato  1   2 , Marianna D'Anca  2 , Gianluca Martino Tartaglia  1   2 , Massimo Del Fabbro  1   2 , Elio Scarpini  2 , Daniela Galimberti  1   2
Affiliations
Review

Treatment of Alzheimer's Disease: Beyond Symptomatic Therapies

Francesca R Buccellato et al. Int J Mol Sci. .

Abstract

In an ever-increasing aged world, Alzheimer's disease (AD) represents the first cause of dementia and one of the first chronic diseases in elderly people. With 55 million people affected, the WHO considers AD to be a disease with public priority. Unfortunately, there are no final cures for this pathology. Treatment strategies are aimed to mitigate symptoms, i.e., acetylcholinesterase inhibitors (AChEI) and the N-Methyl-D-aspartate (NMDA) antagonist Memantine. At present, the best approaches for managing the disease seem to combine pharmacological and non-pharmacological therapies to stimulate cognitive reserve. Over the last twenty years, a number of drugs have been discovered acting on the well-established biological hallmarks of AD, deposition of β-amyloid aggregates and accumulation of hyperphosphorylated tau protein in cells. Although previous efforts disappointed expectations, a new era in treating AD has been working its way recently. The Food and Drug Administration (FDA) gave conditional approval of the first disease-modifying therapy (DMT) for the treatment of AD, aducanumab, a monoclonal antibody (mAb) designed against Aβ plaques and oligomers in 2021, and in January 2023, the FDA granted accelerated approval for a second monoclonal antibody, Lecanemab. This review describes ongoing clinical trials with DMTs and non-pharmacological therapies. We will also present a future scenario based on new biomarkers that can detect AD in preclinical or prodromal stages, identify people at risk of developing AD, and allow an early and curative treatment.

Keywords: Alzheimer’s disease (AD); disease-modifying therapy (DMT); drug; monoclonal antibody (mAb); small molecules; therapy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Summary of Alzheimer’s disease (AD) treatment strategies in clinical trials. Created with Biorender.com.
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References

    1. Prince M.J. S3-01-01: Prevention report from Alzheimer’s disease international (ADI) Alzheimer’s Dement. 2015;11:210. doi: 10.1016/j.jalz.2015.07.214. - DOI
    1. Nichols E., Steinmetz J.D., Vollset S.E., Fukutaki K., Chalek J., Abd-Allah F., Abdoli A., Abualhasan A., Abu-Gharbieh E., Akram T.T., et al. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: An analysis for the Global Burden of Disease Study 2019. Lancet Public Health. 2022;7:e105–e125. doi: 10.1016/S2468-2667(21)00249-8. - DOI - PMC - PubMed
    1. Cummings J., Zhou Y., Lee G., Zhong K., Fonseca J., Cheng F. Alzheimer’s disease drug development pipeline: 2023. Alzheimer’s Dement. Transl. Res. Clin. Interv. 2023;9:e12385. doi: 10.1002/trc2.12385. - DOI - PMC - PubMed
    1. Selkoe D.J., Hardy J. The amyloid hypothesis of Alzheimer’s disease at 25 years. EMBO Mol. Med. 2016;8:595–608. doi: 10.15252/emmm.201606210. - DOI - PMC - PubMed
    1. Fontana I.C., Zimmer A.R., Rocha A.S., Gosmann G., Souza D.O., Lourenco M.V., Ferreira S.T., Zimmer E.R. Amyloid-β oligomers in cellular models of Alzheimer’s disease. J. Neurochem. 2020;155:348–369. doi: 10.1111/jnc.15030. - DOI - PubMed