Shaping the future of Alzheimer’s treatment with a combination of best-of-class drugs…
Therapies to prevent Alzheimer’s disease (AD) progression remain a great, yet unmet, medical need. FDA-approved acetylcholinesterase (AChE) inhibitor drugs, such as donepezil, rivastigamine and galantamine, are indicated for symptomatic relief in patients with mild to moderate AD. However, none of the drugs approved for AD are disease-modifying treatments that affect the underlying pathophysiology of the disease, and so the duration of their benefit is short. The development of successful disease-modifying treatments, in contrast, would have a long-term beneficial effect on the course of AD progression.
To date, no multi-functional and disease-modifying treatment exists for AD. The current standard of care for the treatment of patients with AD consists of the use of AChE inhibitors and NMDA receptor antagonists, which currently are the only FDA-approved treatments for Alzheimer’s disease.
While these drugs may help improve cognition and mask the symptoms of AD, they do not treat the underlying disease nor delay its progression. The effectiveness of AChE inhibitors and NMDA receptor antagonists varies across the population. In some cases, their effects may only last for a limited time—6 to 12 months. These drugs are approved for specific AD stages, and none are approved for mild cognitive impairment. Thus, these drugs typically are not prescribed until the disease has already progressed to the mild-to-moderate stage.
The treatment of AD will require addressing the two main pillars of pathogenesis. The advent and spread of neurotoxic oligomeric aggregates of beta-amyloid is widely regarded as one key trigger leading to neuronal dysfunction, damage and death in AD progression.