Franke A G, Lieb K, Fellgiebel A
Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz.
Fortschr Neurol Psychiatr. 2009 Jun;77(6):326-33. doi: 10.1055/s-0028-1109378. Epub 2009 Jun 5.
Until today the pharmacological therapy of Alzheimer's disease (AD) is still limited to symptomatic temporary improvement or stabilization of cognitive performance and activities of daily living, and the reduction of neuropsychiatric symptoms of the disease. Available symptomatic treatment options are the acetylcholinesterase inhibitors (ACh-I) donepezil, galantamine, rivastigmine, and the partial N-Methyl-D-Aspartat-(NMDA)-antagonist memantine. Further substances with symptomatic targets, especially selective acetylcholine and histamine receptors, are currently under development. Numerous of disease-modifying substances mainly targeting components of the amyloidogenic pathway of AD are presently studied in different phases of preclinical and clinical trials. Against earlier expectations which derived from promising preclinical immunization studies the breakthrough of disease-modification in AD is not in sight yet. Aim of this review is to summarize established pharmacological treatment options and the stage of development of upcoming symptomatic and disease-modifying substances of AD.
直到今天，阿尔茨海默病（AD）的药物治疗仍然局限于对认知功能和日常生活活动进行症状性的临时改善或稳定，以及减少该疾病的神经精神症状。现有的症状性治疗选择包括乙酰胆碱酯酶抑制剂（ACh-I）多奈哌齐、加兰他敏、卡巴拉汀，以及部分N-甲基-D-天冬氨酸（NMDA）拮抗剂美金刚。目前正在研发其他具有症状性靶点的物质，尤其是选择性乙酰胆碱和组胺受体。许多主要针对AD淀粉样蛋白生成途径成分的疾病修饰物质目前正处于临床前和临床试验的不同阶段进行研究。与早期基于有前景的临床前免疫研究的预期相反，AD疾病修饰方面的突破仍未见曙光。本综述的目的是总结已确立的药物治疗选择以及AD即将出现的症状性和疾病修饰物质的研发阶段。
