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Perspective: Minimally clinically important "symptomatic" benefit associated with disease modification resulting from anti-amyloid immunotherapy.
Alzheimers Dement (N Y)
January 2025
Unlabelled: Despite some skepticism regarding the amyloid hypothesis, there is growing evidence that clearing amyloid by targeting specific species of amyloid (plaque, oligomers, fibrils, and protofibrils) for removal has therapeutic benefits. Specifically, there is growing evidence that, in mild cognitive impairment and mild dementia due to Alzheimer's disease (AD), robust and aggressive removal of amyloid can slow cognitive decline as measured by global instruments, composite measures, and cognitive testing. Furthermore, clinical efficacy signals coupled with clear biomarker changes provide the first evidence of disease modification.
View Article and Find Full Text PDFBrain aging rejuvenation factors in adults with genetic and sporadic neurodegenerative disease.
Brain Commun
January 2025
Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA 94158, USA.
The largest risk factor for dementia is age. Heterochronic blood exchange studies have uncovered age-related blood factors that demonstrate 'pro-aging' or 'pro-youthful' effects on the mouse brain. The clinical relevance and combined effects of these factors for humans is unclear.
View Article and Find Full Text PDFTherapeutic Challenges Derived from the Interaction Among Apolipoprotein E, Cholesterol, and Amyloid in Alzheimer's Disease.
Int J Mol Sci
November 2024
Departamento de Medicina, Facultad de Ciencias de la Salud, Universidad de Oviedo, ES-33006 Oviedo, Spain.
The isoform E4 of the Apolipoprotein E (ApoE) represents one of the strongest genetic risk factors for late-onset Alzheimer's disease (AD). ApoE has key roles in cholesterol transport and amyloid-β (Aβ) metabolism, which are both central to AD pathogenesis. The E4 isoform has been implicated in reduced cholesterol homeostasis, increased Aβ aggregation, and heightened tau phosphorylation, contributing to amyloid plaques and neurodegeneration.
View Article and Find Full Text PDFPearls and Oy-sters: A Patient on Lecanemab Newly Diagnosed With Atrial Fibrillation.
Neurology
December 2024
From the Department of Neurology (D.R., A.J.L.), Duke University School of Medicine, Durham; and Department of Surgery (B.A.Z.), Duke University, Durham, NC.
Article Synopsis
- * Her CHADS-VASc score of 6 indicates a high risk for stroke, typically necessitating anticoagulation treatment.
- * However, the use of anticoagulants is not recommended for patients on lecanemab, leading to a management dilemma that requires careful consideration and potential alternative solutions.
Passive anti-amyloid β immunotherapy in Alzheimer's disease-opportunities and challenges.
Lancet
November 2024
Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany; German Center for Neurodegenerative Diseases, Bonn, Cologne, Germany; Excellence cluster on cellular stress response in aging associated disease, University of Cologne, Cologne, Germany.
Article Synopsis
- The paper discusses the introduction of a new type of immunotherapy for Alzheimer's, focusing on the implications of how, when, and who should be treated with it.
- It reviews key clinical trial results for three treatments: aducanumab, lecanemab, and donanemab, along with recommendations for patient selection and safety monitoring.
- The authors highlight the shift from syndrome-based care to early, biomarker-guided treatments for Alzheimer's, emphasizing the need for changes in healthcare infrastructure to support this approach while also promising potential benefits in slowing disease progression.
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