Advancements in Pharmacology for Alzheimer's Disease: From Symptomatic Treatment to Disease-Modifying Drugs

Abstract

Objective: The primary aim of this study is to evaluate the efficacy and safety of emerging disease-modifying therapies in Alzheimer's disease, comparing their effects with traditional symptomatic treatments.

Methods: This randomized, double-blind, placebo-controlled trial enrolled 200 participants diagnosed with mild to moderate Alzheimer's disease. Participants were randomly assigned to one of four groups: (1) symptomatic treatment with Donepezil, (2) symptomatic treatment with Memantine, (3) disease-modifying therapy with a monoclonal anti-amyloid antibody (e.g., Aducanumab), or (4) placebo. The primary endpoint was the change in cognitive function, assessed using the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) over 12 months. Secondary outcomes included changes in functional status (Activities of Daily Living scale), quality of life (QoL-AD), and adverse events.

Results: Cognitive Function: The disease-modifying therapy group showed a statistically significant reduction in ADAS-Cog scores compared to both symptomatic treatment and placebo groups (p < 0.05), indicating potential disease-modifying effects.

 Functional Status and Quality of Life: No significant differences were observed between symptomatic treatments and the placebo in improving functional status. However, patients in the disease-modifying group demonstrated improvements in the QoL-AD scores (p < 0.05).

 Adverse Events: Both symptomatic treatments and disease-modifying therapies were well tolerated. The most common adverse events in the disease-modifying therapy group were mild infusion-related reactions and headaches, which resolved over time.

Conclusions: This study suggests that disease-modifying therapies targeting amyloid plaques may offer a promising approach to slowing cognitive decline in Alzheimer's disease. Although symptomatic treatments remain the mainstay of current care, disease-modifying drugs could transform the therapeutic landscape for AD, offering hope for halting or slowing disease progression. Larger, long-term studies are needed to confirm the durability of these effects and their potential role in clinical practice.