Recent treatment approaches for Alzheimer’s disease with monoclonal antibodies targeting amyloid-β

Abstract

Alzheimer’s disease (AD) is the most common neurodegenerative disease in aging, with a complex etiology. AD is associated with amyloid-β and tau protein accumulation. Although it has been a focus of research for decades, there is no effective treatment for AD. Currently used memantine and acetylcholinesterase inhibitors (donepezil, galantamine, and rivastigmine) can only slightly reduce symptoms of AD progression. These drugs are not curative and have no clear beneficial effects on the main pathological processes of the AD. In the last decade, many monoclonal antibodies targeting amyloid-β and tau proteins have been developed. Two anti-amyloid-β monoclonal antibodies, aducanumab and lecanemab, have been granted accelerated approvals by the FDA for the treatment of AD. These breakthrough agents constitute the first disease-modifying therapies for AD that can slow the inevitable progression of AD. However, monoclonal antibodies have side effects and, patients must be carefully monitored for the occurrence of amyloid-related imaging abnormalities and infusion reactions. Despite potential harms associated with these immunotherapies, there is still hope that the early onset of AD with the administration of an accurately adjusted dose of these antibodies could provide cognitive and functional benefits.

Keywords

• Alzheimer’s disease
• immunotherapy
• amyloid-β
• aducanumab
• lecanemab

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