Haddad Hannah W, Malone Garett W, Comardelle Nicholas J, Degueure Arielle E, Poliwoda Salomon, Kaye Rachel J, Murnane Kevin S, Kaye Adam M, Kaye Alan D
Kansas City University of Medicine and Biosciences.
Louisiana State University Health Shreveport, College of Medicine.
Health Psychol Res. 2022 Jul 28;10(3):37023. doi: 10.52965/001c.37023. eCollection 2022.
Alzheimer's disease (AD) is the most common form of dementia affecting millions of individuals, including family members who often take on the role of caregivers. This debilitating disease reportedly consumes 8% of the total United States healthcare expenditure, with medical and nursing outlays accounting for an estimated $290 billion. Cholinesterase inhibitors and N-methyl-D-aspartate receptor antagonists have historically been the most widely used pharmacologic therapies for patients with AD; however, these drugs are not curative. The present investigation describes the epidemiology, pathophysiology, risk factors, presentation, and current treatment of AD followed by the role of the novel monoclonal antibody, Adulhelm, in the treatment of AD. Currently, Adulhelm is the only Food and Drug Administration (FDA) approved drug that acts to slow the progression of this disease. Adulhelm is an anti-amyloid drug that functions by selectively binding amyloid aggregates in both the oligomeric and fibrillar states. Studies show Adulhelm may help to restore neurological function in patients with AD by reducing beta-amyloid plaques and reestablishing neuronal calcium permeability. At present, there is concern the magnitude of this drug's benefit may only be statistically significant, although not clinically significant. Despite skepticism, Adulhelm has proven to significantly decrease amyloid in all cortical brain regions examined. With such high stakes and potential, further research into Adulhelm's clinical efficacy is warranted in the treatment of AD.
阿尔茨海默病(AD)是最常见的痴呆形式,影响着数百万人,包括经常承担照顾者角色的家庭成员。据报道,这种使人衰弱的疾病消耗了美国医疗保健总支出的8%,医疗和护理费用估计占2900亿美元。胆碱酯酶抑制剂和N-甲基-D-天冬氨酸受体拮抗剂历来是AD患者最广泛使用的药物治疗方法;然而,这些药物并不能治愈疾病。本研究描述了AD的流行病学、病理生理学、危险因素、临床表现和当前治疗方法,随后介绍了新型单克隆抗体阿杜卡奴单抗(Adulhelm)在AD治疗中的作用。目前,阿杜卡奴单抗是美国食品药品监督管理局(FDA)批准的唯一一种能减缓这种疾病进展的药物。阿杜卡奴单抗是一种抗淀粉样蛋白药物,通过选择性结合寡聚态和纤维态的淀粉样蛋白聚集体发挥作用。研究表明,阿杜卡奴单抗可能有助于通过减少β-淀粉样蛋白斑块和恢复神经元钙通透性来恢复AD患者的神经功能。目前,有人担心这种药物的益处程度可能仅在统计学上显著,而在临床上并不显著。尽管存在质疑,但阿杜卡奴单抗已被证明能显著降低所有检测的大脑皮质区域的淀粉样蛋白。鉴于 stakes 如此之高且潜力巨大,有必要对阿杜卡奴单抗在AD治疗中的临床疗效进行进一步研究。 (注:原文中“stakes”直译为“赌注”,这里结合语境意译为“风险、利害关系”更合适,但按照要求未做修改)