Pharmacotherapeutic combinations for the treatment of Alzheimer's Disease Pharmacotherapy
Pharmacotherapeutic combinations for the treatment of Alzheimer's Disease Pharmacotherapy
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用于治疗阿尔茨海默病的药物治疗组合
DOI：
10.1080/14656566.2022.2042514
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发表时间：
2022
影响因子：
3.2
通讯作者：
Mimura M.
中科院分区：
文献类型：
--
作者：
Nagata T;Shinagawa S;Nakajima S;Noda Y;Mimura M.
阿尔茨海默病（Alzheimer's disease，AD）是最常见的痴呆形式，目前有四种药物可作为对症治疗：三种胆碱酯酶抑制剂（ChEI）和美金刚。2021年6月，aducanumab在美国以加速审批途径获批，作为首个靶向脑内β-淀粉样蛋白（Aβ）级联反应的新型推定疾病修饰疗法（p-DMT）。几种单一疗法的组合，以解决神经退行性疾病的多因素发病机制是一个预期的下一步。Areas coveredThe胆碱能假说和淀粉样蛋白级联假说已被提出作为解释AD的发病机制。鉴于这些假设的基础上的单一疗法的有效性有限，使用组合疗法的方法正在试图解决AD发病机制的复杂性，包括假定的致病蛋白质相关的神经变性，神经递质和神经炎症，在一个全面的mathematic.Expert opinionThe疗效的初始或添加组合的方法，以抵消神经退行性过程和功能恶化进行了研究。对症治疗与批准的抗痴呆药物（一种ChEI和美金刚）的组合已被发现在功能上对中度严重的疾病阶段有效。此外，涉及p-DMT、对症治疗和神经再生的组合策略在未来可能是有用的。
IntroductionAlzheimer’s disease (AD) is the most common form of dementia, and four medications are currently available as symptomatic therapies: three cholinesterase inhibitors (ChEI) and memantine. In June 2021, aducanumab was approved in the United States under an accelerated approval pathway as the first novel putative disease-modifying therapy (p-DMT) targeting theβ-amyloid (Aβ) cascade in the brain. The combination of several monotherapies to address the multifactorial pathogenesis of neurodegenerative diseases is an anticipated next step.Areas coveredThe cholinergic hypothesis and the amyloid cascade hypothesis have been proposed as explanations for the pathogenesis of AD. Given the limited effectiveness of monotherapies based on these hypotheses, approaches using combination therapy are attempting to address the complexity of AD pathogenesis, including putative causative proteins-related neurodegeneration, neurotransmitters, and neuroinflammation, in a comprehensive manner.Expert opinionThe efficacy of an initial or add-on combination approach to counteracting neurodegenerative processes and functional deterioration has been investigated. The combination of symptomatic therapies with approved anti-dementia medicines (one ChEI and memantine) has been found to be functionally effective for a moderately severe disease stage. Furthermore, combination strategies involving p-DMTs, symptomatic therapies, and neuro-regeneration may be useful in the future.