Grimmer Timo
Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, München, Germany.
Fortschr Neurol Psychiatr. 2022 Jul;90(7-08):352-360. doi: 10.1055/a-1802-4837. Epub 2022 May 19.
The development of new therapies to treat Alzheimer's disease is a focus of global drug discovery. Research is being conducted into more potent therapies for symptomatic treatment, particularly for behavioral disturbances, but also into drugs that intervene in the pathophysiology of the disease, with the aim of halting or at least slowing the progression of the disease. To this end, the focus of identifying people with Alzheimer's disease is shifting to stages of pre-dementia such as that of Mild Cognitive Impairment (MCI), almost synonymous with prodromal AD, or even to asymptomatic stages. Currently, passive immunization using monoclonal antibodies against Aβ42 has shown the most encouraging results. However, it has not been possible to demonstrate statistically significant differences on the primary target parameters in multiple completed pivotal trials. The anti-amyloid antibody aducanumab received conditional preliminary approval in the U.S. based on amyloid reduction; approval for its use in Europe is an ongoing process. Current pharmacological treatments of Alzheimer's disease offer limited symptomatic benefit. No drugs to delay progression of the disease is yet on the market in Germany. Therefore, it is recommended that patients, especially those in pre-dementia stages or at the onset of Alzheimer's disease, be encouraged to participate in clinical trials in order to help develop new drugs that are more effective in the treatment of this disease and that can then benefit many more patients in the future.
开发治疗阿尔茨海默病的新疗法是全球药物研发的一个重点。目前正在研究更有效的对症治疗方法,特别是针对行为障碍的治疗方法,同时也在研究干预该疾病病理生理学的药物,目的是阻止或至少减缓疾病的进展。为此,识别阿尔茨海默病患者的重点正转向轻度认知障碍(MCI)等痴呆前阶段,MCI几乎与前驱性阿尔茨海默病同义,甚至转向无症状阶段。目前,使用抗Aβ42单克隆抗体的被动免疫疗法已显示出最令人鼓舞的结果。然而,在多项已完成的关键试验中,尚未能够在主要目标参数上证明具有统计学意义的差异。抗淀粉样蛋白抗体阿杜卡那单抗基于淀粉样蛋白减少在美国获得了有条件的初步批准;其在欧洲的使用批准正在进行中。目前阿尔茨海默病的药物治疗仅提供有限的对症益处。德国尚无延缓疾病进展的药物上市。因此,建议鼓励患者,特别是那些处于痴呆前阶段或阿尔茨海默病发病初期的患者参加临床试验,以帮助开发对该疾病治疗更有效的新药,从而使更多患者在未来受益。