Impact on Self
Impact on Caregivers
Current treatment options
New Horizons in Alzheimer’s Treatment
- ARIA-edema (ARIA-E)*
- ARIA-hemosiderin deposition (ARIA-H) microhemorrhage*
- ARIA-H superficial siderosis*
- Headache
- Fall
- Diarrhoea
- Confusion/delirium/altered mental status/disorientation
- Hypersensitivity (angioedema, urticaria)
- Immunogenicity
Conclusion
Incidences of AD have reached an all time high. At present, someone in the U.S. develops AD every 66 seconds. By 2050, experts speculate that a new case will be reported every 33 seconds (1).
The accelerated approval granted by FDA to Aducanumab indicates that there is a dire need for newer treatment modalities for AD. Increased understanding of the pathophysiology of AD has led to the development and testing of many new agents.
One of the drugs currently under trial is Donanemab, a monoclonal antibody that can potentially decrease amyloid beta-plaque and slow the progression of Tau proteins in the brain. Another drug under development is Lecanemab, an anti-amyloid beta protofibril antibody (18).
In 2018, approximately 112 drugs for AD were in phase I, II, or III trials. While 63% of them were disease-modifying therapies (DMTs) aimed at beta-amyloid or tau proteins, 25% of the drugs in development were being tested for their ability to enhance cognition. The rest of the agents were intended to decrease behavioural symptoms such as agitation, apathy, and sleep disturbances (9).
Multiple trials are also currently in progress for the development of Alzheimer’s vaccine.
As many as 9 vaccines are under trial, with the first human trials started for an intranasal vaccine by Brigham and Women’s Hospital, Boston, Massachusetts using Protollin, an immunomodulator, to stimulate the immune system (19).
While all these promising treatment options are certainly in progress, the Aducanumab trials have raised some important questions – Are amyloid plaques really responsible for the cognitive decline in Alzheimer’s disease? Or are there other factors that come into play? The results of the trials suggest that it might be more prudent for researchers to look into the mechanism of ageing instead, and study the biological processes that go awry and lead to the development of Alzheimer’s.
References
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19. Brigham and Women’s Hospital, News Release, November 16, 2021.