Disease-modifying drugs in Alzheimer's disease.
Disease-modifying drugs in Alzheimer's disease.
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DOI：
10.2147/dddt.s41431
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发表时间：
2013-12-06
期刊：
影响因子：
--
通讯作者：
Galimberti D
中科院分区：
文献类型：
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作者：
Ghezzi L;Scarpini E;Galimberti D
阿尔茨海默病(AD)是一种与年龄相关的神经退行性疾病，也是导致痴呆的最常见原因。阿尔茨海默病的早期特征是短期记忆丧失。一旦病情发展，患者在方向感、口头交流、计算、学习能力和认知思维方面都会出现困难。病程的中位数为10年。病理特征是淀粉样β蛋白(所谓的老年斑)和tau蛋白以神经原纤维缠结的形式沉积。目前，欧洲药品管理局批准了两类治疗AD的药物，即用于轻度至中度AD的乙酰胆碱酯酶抑制剂，以及用于中度和重度AD的N-甲基-D-天冬氨酸受体拮抗剂美金刚。使用乙酰胆碱酯酶抑制剂或美金刚治疗的目的是减缓进展和控制症状，而正在开发的药物旨在修改导致AD的病理步骤。在此，我们综述了现有的乙酰胆碱酯酶抑制剂和美金刚的临床特征、药理特性和成本-效果，重点介绍了旨在干扰淀粉样β蛋白的疾病修饰药物，包括疫苗接种、被动免疫和tau沉积。
Alzheimer’s disease (AD) is an age-dependent neurodegenerative disorder and the most common cause of dementia. The early stages of AD are characterized by short-term memory loss. Once the disease progresses, patients experience difficulties in sense of direction, oral communication, calculation, ability to learn, and cognitive thinking. The median duration of the disease is 10 years. The pathology is characterized by deposition of amyloid beta peptide (so-called senile plaques) and tau protein in the form of neurofibrillary tangles. Currently, two classes of drugs are licensed by the European Medicines Agency for the treatment of AD, ie, acetylcholinesterase inhibitors for mild to moderate AD, and memantine, an N-methyl-D-aspartate receptor antagonist, for moderate and severe AD. Treatment with acetylcholinesterase inhibitors or memantine aims at slowing progression and controlling symptoms, whereas drugs under development are intended to modify the pathologic steps leading to AD. Herein, we review the clinical features, pharmacologic properties, and cost-effectiveness of the available acetylcholinesterase inhibitors and memantine, and focus on disease-modifying drugs aiming to interfere with the amyloid beta peptide, including vaccination, passive immunization, and tau deposition.