Treatment of Alzheimer's Disease in the New Era of Monoclonal Antibodies Against Cerebral Amyloid-β: Pharmacological Prescription and Knowledge in Argentina

Background: Alzheimer's disease (AD) presents a significant global health challenge. Understanding the current and upcoming treatment landscape is crucial for effectively managing patients. Objective: The aim of this study was to assess the pattern of prescription and knowledge about new therapies by physicians who treat AD patients in Argentina. Methods: A cross- sectional and analytic study was conducted. A survey was elaborated about pharmacological treatment in AD. Statistical analysis of answers of specialists in cognitive disorders (SCD), non-specialists in cognitive disorders (NSCD), recommended treatment, non-recommended treatment (NRT), and off-label treatment was performed. Results: 155 physicians answered the survey. A 19.35% prescribed at least one NRT for dementia. 78.06% prescribed at least an off-label treatment or an NRT for mild cognitive impairment (MCI). 31% would prescribe monoclonal antibodies (MABs) against cerebral amyloid-beta (A beta) to AD patients, and 42.6% responded that they were not aware of any adverse effect of these. Quetiapine was the most frequent treatment for psychotic symptoms (88.4%) and escitalopram (32.3%) for apathy. A 70% of potential prescribers of MABs (n = 100) would request biomarkers of cerebral A beta in the initial assessment. There were significant differences between the responses of SCD and NSCD regarding the prescription of MABs (52.17% versus 23.08, respectively) and knowledge about adverse events (76.09% versus 38.46%, respectively). Conclusions: A considerable percentage of physicians indicated NRT and off-label medication in MCI and dementia. In Argentina, there are many physicians who would indicate a MABs for AD, but many are not completely aware of its safety profile.