Haddad Hannah W, Malone Garett W, Comardelle Nicholas J, Degueure Arielle E, Kaye Adam M, Kaye Alan D
College of Medicine, Kansas City University of Medicine and Biosciences, Kansas City, MO.
College of Medicine, Louisiana State University Health Shreveport, Shreveport, LA.
Health Psychol Res. 2022 Jan 30;10(1):31925. doi: 10.52965/001c.31925. 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 as caregiver. 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. This review discusses the epidemiology, pathophysiology, risk factors, presentation, and current treatment of AD followed by the role of the novel monoclonal antibody, aducanumab, in treatment of AD. Currently aducanumab is the only Food and Drug Administration (FDA) approved drug that acts to slow progression of this disease. Aducanumab is an anti-amyloid drug which functions by selectively binding amyloid aggregates in both the oligomeric and fibrillar states. Studies show aducanumab may help to restore neurological function in patients with AD by reducing beta-amyloid plaques and reestablishing neuronal calcium permeability. However, there is concern the magnitude of this drug's benefit may only be statistically significant and not clinically significant. Despite this skepticism, aducanumab has proven to significantly decrease amyloid in all cortical brain regions examined. In summary, aducanumab has provided hope for those working toward the goal of providing patients a safe and viable treatment option in the management 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达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。本综述讨论了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单抗在AD治疗中的作用。目前，阿杜卡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该疾病进展的药物。阿杜卡单抗是一种抗淀粉样蛋白药物，其作用机制是选择性结合寡聚态和纤维态的淀粉样蛋白聚集体。研究表明，阿杜卡单抗可能通过减少β-淀粉样蛋白斑块和恢复神经元钙通透性来帮助恢复AD患者的神经功能。然而，有人担心这种药物的益处可能仅在统计学上有意义，而在临床上没有意义。尽管存在这种怀疑，但阿杜卡单抗已被证明能显著减少所有检测的大脑皮质区域中的淀粉样蛋白。总之，阿杜卡单抗为那些致力于为AD患者提供安全可行治疗选择的人带来了希望。
