a Department of Clinical and Experimental Medicine , Unit of Neurology, University of Pisa , Pisa , Italy.
Expert Opin Pharmacother. 2018 Oct;19(15):1643-1653. doi: 10.1080/14656566.2018.1519548. Epub 2018 Sep 13.
Dementia with Lewy bodies (DLB) is the second most common type of dementia in people over 65 years of age. Given the complex clinical phenotype, the management of DLB may be challenging, especially considering that there is limited evidence about specific interventions, and there are currently no Food and Drug Administration (FDA)/European Medicines Agency (EMA)-approved medications.
This article provides an overview of the current pharmacotherapy in DLB and gives review to the most recent drug candidates in clinical trials.
Commonly prescribed drugs are primarily aimed at treating the most troublesome clinical features of DLB. Although these medications provide some benefit to symptoms, there is, unfortunately, a lack of DLB-specific evidence on effective treatments and their off-label use. Indeed, most treatments used come from clinical trials on patients with Alzheimer's disease or Parkinson's disease. Thus, there is an urgent need for randomized clinical trials in DLB patients. Despite several challenges, potential new drugs are in ongoing clinical trials; furthermore, as our understanding of molecular and cellular mechanisms underlying DLB broaden, it is likely that we will identify novel drug targets for the development of better and more effective symptomatic products and disease-modifying therapies.
路易体痴呆(DLB)是 65 岁以上人群中第二常见的痴呆类型。鉴于其复杂的临床表型,DLB 的管理可能具有挑战性,特别是考虑到目前关于特定干预措施的证据有限,并且目前没有获得美国食品和药物管理局(FDA)/欧洲药品管理局(EMA)批准的药物。
本文概述了 DLB 的当前药物治疗,并对临床试验中最新的候选药物进行了综述。
常用的处方药物主要针对治疗 DLB 最麻烦的临床特征。尽管这些药物对症状有一定的益处,但不幸的是,缺乏针对有效治疗方法的 DLB 特异性证据,并且这些药物的使用属于超适应证用药。事实上,大多数使用的治疗方法都来自于针对阿尔茨海默病或帕金森病患者的临床试验。因此,迫切需要针对 DLB 患者开展随机临床试验。尽管存在诸多挑战,但仍有一些潜在的新药正在进行临床试验;此外,随着我们对 DLB 潜在的分子和细胞机制的理解不断深入,我们很可能会确定新的药物靶点,以开发出更好、更有效的对症治疗产品和疾病修饰疗法。