Aducanumab Therapy to Treat Alzheimer’s Disease: A Narrative Review

Author:

Beshir Semira Abdi1ORCID,Aadithsoorya A. M.2ORCID,Parveen Affana3ORCID,Goh Sheron Sir Loon4ORCID,Hussain Nadia5ORCID,Menon Vineetha Bharathan6ORCID

Affiliation:

1. Clinical Pharmacy & Pharmacotherapeutics Department, Dubai Pharmacy College, Dubai, UAE

2. College of Medicine, Gulf Medical University, Ajman, UAE

3. College of Pharmacy, Gulf Medical University, Ajman, UAE

4. Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

5. Department of Pharmaceutical Sciences, College of Pharmacy, Al Ain University, Al Ain, Abu Dhabi, UAE

6. Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, UAE

Abstract

Background. Aducanumab, a new monoclonal antibody that targets β-amyloid aggregates, has been granted conditional approval by the U.S. FDA for treatment of mild Alzheimer’s disease (AD). The approval of this drug without a confirmed significant clinical impact has resulted in several debates. Objective. In this narrative review, aducanumab approval-related controversy, the drug’s pharmacokinetics and pharmacodynamic characteristics, evidence from the efficacy and safety trials of aducanumab, implications of the drug approval, and the future directions in the management of patients with AD are summarized. Methods. Using relevant keywords, Google Scholar, Web of Science, and MEDLINE databases and manufacturer’s website were searched. Results. Infusion of aducanumab at a higher dose resulted in a modest slowing of cognitive decline among patients with mild cognitive impairment or early-onset AD dementia. The drug however can cause amyloid-related imaging abnormalities. Due to modest impact on cognition, the use of this drug by patients with AD will most likely be limited. The manufacturer is required to run an extended phase IIIb trial to verify the benefit of this drug. Access to therapy requires a careful selection of patients and periodic monitoring to ensure the optimal use of the drug. Conclusion. Despite the limitations, aducanumab is the first disease-modifying therapy approved for the treatment of AD. Aducanumab addresses a part of the pathogenesis of AD; therefore, drugs that can act on multiple targets are needed. In addition, the search for preventive strategies, validated plasma-based assays, and newer drugs for AD, which are effective, safe, convenient, and affordable, is vital.

Publisher

Hindawi Limited

Subject

Behavioral Neuroscience,Cellular and Molecular Neuroscience,Cognitive Neuroscience,Neurology (clinical),Neurology,Aging,General Medicine

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