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Current and Emerging Drug Treatment Options for Alzheimer’s Disease

A Systematic Review

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Abstract

Alzheimer’s disease (AD) is a progressive and ultimately fatal condition that causes debilitating memory loss and extensive deterioration of cognitive and functional abilities. Currently available treatments for AD (donepezil, rivastigmine, galantamine and memantine) are symptomatic and do not decelerate or prevent the progression of the disease. These therapies demonstrate modest, but particularly consistent, benefit for cognition, global status and functional ability. The search for disease-modifying interventions has focused largely on compounds targeting the amyloid-β pathway. To date, the treatments targeting this pathway, such as tramiprosate and semagacestat, have been unsuccessful in demonstrating efficacy in clinical stages of testing. At this point, it is likely that not only amyloid-β aggregation but other possible neuronal mechanisms — such as hyperphosphorylated tau, neuro-inflammation and other processes — play important roles in the pathophysiology of this multifactorial disorder. Development of better disease models and biomarkers is essential for the advancement of knowledge of the disease mechanisms. This systematic review critically examines the efficacy and safety data for currently approved drugs and emerging treatments in AD, as well as discussing the present and future directions of innovation in this field.

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Acknowledgements

Dr Nathan Herrmann has received research funding, consultation fees and (or) speakers’ honoraria from Lundbeck, Pfizer, Janssen-Ortho, Novartis and Sonexa Therapeutics. Sarah Chau and Ida Kircanski have no conflicts of interest that are relevant to this review. Dr Krista Lanctôt has received research funding, consultation fees and (or) speakers’ honoraria from Abbott, Lundbeck, Pfizer, Janssen-Ortho and Sonexa Therapeutics. None of the four authors is an employee of Lundbeck, Pfizer, Janssen-Ortho or Novartis (the makers of cholinesterase inhibitors and memantine in Canada) or is a shareholder in any of these companies. No sources of funding were provided for the preparation of this review.

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Herrmann, N., Chau, S.A., Kircanski, I. et al. Current and Emerging Drug Treatment Options for Alzheimer’s Disease. Drugs 71, 2031–2065 (2011). https://doi.org/10.2165/11595870-000000000-00000

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