Recent advances in Alzheimer's Disease management

Abstract

Alzheimer’s disease is very common type of dementia in old age which is slowly progressive neurodegenerative disease associated with loss of cognitive functions. It is caused by several pathological pathways like amyloid- β (Aβ) deposition, hyperphosphorylated tau protein, excessive glutamatergic stimulation, cholinergic disorder, and neuroinflammation and oxidative stress. Currently, most of the drugs available for the management of Alzheimer disease, like cholinesterase enzyme inhibitors (donepezil, rivastigmine, galantamine) and N-methyl d-aspartate (NMDA) antagonist, memantine, are effective in treating the symptoms but do not cure the disease. Various research projects on Alzheimer’s disease have failed or have been abandoned in the past decade due to adverse effects or lack of the efficacy. This can be due to starting of therapy in the late stages of disease, inappropriate drug doses or an inadequate understanding of the pathophysiology of AD. Recently there have been success in disease management with the approval of adacanumab and donanemab-azbt, which have been recently approved by FDA. Furthermore, there are many ongoing trials which are currently in various phases of development which, if successful, would provide multiple options to choose from, for better management of AD. This review highlights such recent advances as well as future targets in the disease treatment, which would aid physicians in optimizing patient care.