Alzheimer’s Disease :: Therapeutic approaches to Alzheimer’s Disease

Alzheimer’s disease is an age-related progressive neurodegenerative disorder with an enormous unmet medical need. It is the most common form of dementia affecting 5% of adults over 65 years. In view of our ageing society the number of patients, as well as the economical and social impact, is expected to grow dramatically in the future. Currently available medications appear to be able to produce moderate symptomatic benefits but not to stop disease progression.

The search for novel therapeutic approaches targeting the presumed underlying pathogenic mechanisms has been a major focus of research and it is expected that novel medications with disease-modifying properties will emerge from these efforts in the future. In this review, currently available drugs as well as novel therapeutic strategies, in particular those targeting amyloid and tau pathologies, are discussed.

Medications for the treatment of Alzheimer’s disease that are available today include cholinesterase inhibitors and the NMDA-receptor antagonist, memantine. These drugs are safe and in several large and independent studies, they were reported to produce moderate symptomatic benefits. At present, however, there is no treatment available that can stop the progressive deterioration of cognitive functions in the Alzheimer’s disease patients. The development of novel drugs with strong disease-modifying properties therefore represents one of the biggest unmet medical needs today.

The pathophysiology of Alzheimer’s disease and the search for novel therapeutic strategies have been a major focus of academic and industry research for several years. The predominant hypothesis to explain the pathogenesis is the amyloid cascade hypothesis, and consequently, several of the novel and promising therapeutic strategies are specifically addressing the amyloid pathology.

Whether anti A?-immunotherapy, small molecule secretase inhibitors, other A? lowering approaches or aggregation inhibitors will turn out to be safe and will be able to stop or slow down disease progression remains to be seen.

Study conducted by:

Hans-Wolfgang Klafki1, Matthias Staufenbiel2, Johannes Kornhuber1 and Jens Wiltfang1,
1 Department of Psychiatry and Psychotherapy, University of Erlangen-Nuremberg Erlangen, Germany
2 Novartis Institutes for Biomedical Research, Basel Switzerland


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