Present Algorithms and Future Treatments for Alzheimer's Disease

被引:85
作者
Grossberg, George T. [1 ]
Tong, Gary [2 ]
Burke, Anna D. [3 ]
Tariot, Pierre N. [4 ]
机构
[1] St Louis Univ, Sch Med, St Louis, MO USA
[2] Lundbeck, Deerfield, IL USA
[3] Barrow Neurol Inst, Phoenix, AZ 85013 USA
[4] Banner Alzheimers Inst, Phoenix, AZ USA
关键词
Algorithm; Alzheimer's disease; cholinesterase inhibitors; memantine; treatment; NURSING-HOME PLACEMENT; POSTMENOPAUSAL HORMONE-THERAPY; CHOLINESTERASE-INHIBITORS; DOUBLE-BLIND; MEMANTINE TREATMENT; PSYCHOLOGICAL SYMPTOMS; COMBINATION THERAPY; RIVASTIGMINE PATCH; CONTROLLED-TRIAL; OPEN-LABEL;
D O I
10.3233/JAD-180903
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
An estimated 47 million people live with Alzheimer's disease (AD) and other forms of dementia worldwide. Although no disease-modifying treatments are currently available for AD, earlier diagnosis and proper management of the disease could have considerable impact on patient and caregiver quality of life and functioning. Drugs currently approved for AD treat the cognitive, behavioral, and functional symptoms of the disease and consist of three cholinesterase inhibitors (ChEIs) and the N-methyl-D-aspartate receptor antagonist memantine. Treatment of patients with mild to moderate AD is generally initiated with a ChEI. Patients who show progression of symptoms while on ChEI monotherapy may be switched to another ChEI and/or memantine can be added to the treatment regimen. In recent years, putative disease-modifying therapies have emerged that aim to slow the progression of AD instead of only addressing its symptoms. However, many therapies have failed in clinical trials in patients with established AD, suggesting that, once developed, disease-modifying agents may need to be deployed earlier in the course of illness. The goal of this narrative literature review is to discuss present treatment algorithms and potential future therapies in AD.
引用
收藏
页码:1157 / 1171
页数:15
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