RESUMO
BACKGROUND: Alzheimer disease (AD) is a chronic neurodegenerative disorder with complex pathophysiology that affects over 50 million people worldwide. Most drug therapies, to date, have focused on targeting the amyloid-beta (Aß) pathway, but clinical outcomes of anti-Aß antibodies have been unsuccessful and unable to meet their primary endpoints. Similar trends have also been observed in treatments that target the tau pathway. SUMMARY: This paper reviews recent anti-Aß passive monotherapies, since Bapineuzumab, that have progressed to phase 3 clinical trials. Specifically, we discuss the 4 clinical trial programs of Solanezumab (targets Aß monomers), Aducanumab (targets Aß oligomers and plaques), Crenezumab (targets Aß oligomers), and Gantenerumab (targets Aß fibrils) which are all exogenous monoclonal antibodies. We conclude with potential reasons for why they have not met their primary endpoints and discuss lessons learnt from these trials. Key Message: Future disease-modifying trials (DMTs) for AD should be conducted in asymptomatic, Aß-positive individuals. Moreover, potential additive and/or synergistic benefits focusing on anti-Aß and anti-tau drug combinations merit further investigation.
