USE OF MONOCLONAL ANTIBODIES IN THE TREATMENT OF ALZHEIMER'S DISEASE: ADVANCES AND CHALLENGES
DOI:
https://doi.org/10.56238/levv17n60-045Keywords:
Alzheimer’s Disease, Monoclonal Antibodies, Beta-amyloid, Neurodegeneration, TreatmentAbstract
Alzheimer’s disease is a progressive neurodegenerative disorder and the leading cause of dementia worldwide, characterized by cognitive impairment, memory loss, and behavioral changes. In recent decades, advances in understanding the pathophysiology of the disease, particularly related to the accumulation of beta-amyloid peptides and tau protein, have driven the development of new therapeutic strategies. In this context, monoclonal antibodies have emerged as a promising alternative, with the potential to reduce amyloid plaques and slow disease progression. Therefore, this study aimed to analyze the advances and challenges in the use of monoclonal antibodies in the treatment of Alzheimer’s disease. This study is an integrative literature review conducted in the Medline, LILACS, and Science Direct databases. Controlled descriptors from DeCS and MeSH were used and combined with the Boolean operator AND: “Alzheimer’s Disease”, “Monoclonal Antibodies”, and “Beta-Amyloid Peptides”. Articles published between 2020 and 2025 in Portuguese, English, and Spanish were included. The results are expected to highlight the therapeutic benefits and challenges associated with these medications, including clinical efficacy, safety, adverse effects, costs, and access to treatment. Thus, this study contributes to expanding scientific knowledge and supporting future research on innovative therapies for Alzheimer’s disease.
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ANDREWS, S. J.;et al. The complex genetic architecture of Alzheimer's disease: novel insights and future directions. EBioMedicine, v. 90, p. 104511, 2023. DOI: https://doi.org/10.1016/j.ebiom.2023.104511 . Disponível em: https://pubmed.ncbi.nlm.nih.gov/36907103/ . Acesso em: 5 out. 2025.
ANDREWS, Samantha J.; GOATE, Alison. Molecular mechanisms of Alzheimer’s disease. Annual Review of Genomics and Human Genetics, v. 24, p. 47-72, 2023.
ARAI, Heii et al. Safety of switching from lecanemab to donanemab in patients with Alzheimer’s disease. Journal of Alzheimer’s Disease, v. 107, n. 2, p. 494-495, 2025.
BELLENGUEZ, C. et al. New insights into the genetic etiology of Alzheimer's disease and related dementias. Nature Genetics, v. 54, n. 4, p. 412–436, 2022. DOI: https://doi.org/10.1038/s41588-022-01024-z . Disponível em: https://pubmed.ncbi.nlm.nih.gov/35379992/ . Acesso em: 5 out. 2025.
BELLENGUEZ, Celine et al. New insights into the genetic etiology of Alzheimer’s disease and related dementias. Nature Genetics, v. 54, p. 412-436, 2022.
CUMMING, J.; et al Alzheimer's disease drug development pipeline: 2024. Alzheimer's & Dementia (New York, N. Y.), v. 10, n. 2, e12465, 2024. DOI: https://doi.org/10.1002/trc2.12465 . Disponível em: https://pubmed.ncbi.nlm.nih.gov/38659717/. Acesso em: 5 out. 2025.
CUMMINGS, Jeffrey et al. Aducanumab: appropriate use recommendations. Journal of Prevention of Alzheimer’s Disease, v. 8, p. 398-410, 2021.
CUMMINGS, Jeffrey et al. Alzheimer’s disease drug development pipeline: 2024. Alzheimer's & Dementia, v. 20, n. 2, p. 1-21, 2024. DOI: https://doi.org/10.1002/alz.13811.
DE SOUSA, M. N. A.; BEZERR, A. L. D.; DO EGYPTO, I. A. S. Trilhando o caminho do conhecimento: o método de revisão integrativa para análise e síntese da literatura científica. Observatório de la Economía Latinoamericana, [S. l.], v. 21, n. 10, p. 18448–18483, 2023. DOI: 10.55905/oelv21n10-212. Disponível em: https://ojs.observatoriolatinoamericano.com/ojs/index.php/olel/article/view/1902. Acesso em: 5 out. 2025.
FDA - Food and Drug Administration. FDA aprova tratamento para adultos com doença de Alzheimer. Disponível em: https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-treatment-adults-alzheimers-disease. Acesso em: 13 set. 2024.
GAO, S. et al. Interpretation of 10 years of Alzheimer's disease genetic findings in the perspective of statistical heterogeneity. Briefings in Bioinformatics, v. 25, n. 3, bbae140, 2024. DOI: https://doi.org/10.1093/bib/bbae140. Disponível em: https://pubmed.ncbi.nlm.nih.gov/38711368/ . Acesso em: 5 out. 2025.
GAO, Yifan et al. Advances in monoclonal antibody therapies for Alzheimer’s disease. Frontiers in Neuroscience, v. 18, 2024. DOI: https://doi.org/10.3389/fnins.2024.1354010.
HAEBERLEIN, S. Budd et al. Two randomized phase 3 studies of aducanumab in early Alzheimer’s disease. Journal of Prevention of Alzheimer’s Disease, v. 9, n. 2, p. 197-210, 2022.
HASSUNUMA, R. M. et al. Revisão integrativa e redação de artigo científico: uma proposta metodológica em 10 passos. Revista Multidisciplinar em Educação e Meio Ambiente, v. 5, n. 3, 2024. DOI: https://doi.org/10.51161/integrar/rems/4275 . Disponível em: https://www.editoraintegrar.com.br/publish/index.php/rema/article/view/4275. Acesso em: 5 out. 2025.
KAMONDI, A.; et al. A. Epilepsy and epileptiform activity in late-onset Alzheimer disease: clinical and pathophysiological advances, gaps and conundrums. Nature Reviews Neurology, v. 20, n. 3, p. 162–182, 2024. DOI: https://doi.org/10.1038/s41582-024-00932-4. Disponível em: https://pubmed.ncbi.nlm.nih.gov/38356056/. Acesso em: 5 out. 2025.
KAMONDI, Anna et al. Neurological comorbidities in Alzheimer’s disease and their clinical implications. Neurological Sciences, v. 45, p. 1153-1165, 2024.
KNOPMAN, David S.; JONES, David T.; GREICIUS, Michael D. Failure to demonstrate efficacy of aducanumab: analysis of the EMERGE and ENGAGE trials. Neurology, v. 97, n. 7, p. 329-337, 2021.
MINTUN, Mark A. et al. Donanemab in early Alzheimer disease. New England Journal of Medicine, v. 384, p. 1691-1704, 2021.
MINTUN, Mark A. et al. Donanemab in early symptomatic Alzheimer disease: the TRAILBLAZER-ALZ 2 randomized clinical trial. JAMA, v. 330, n. 6, p. 512-527, 2023.
NITRINI, R. Doença de Alzheimer: parte 2 – o presente. Arquivos de Neuro-Psiquiatria, v. 82, 2024. DOI: 10.1055/s-0044-1791755. Disponível em: https://www.thieme-connect.de/products/ejournals/html/10.1055/s-0044-1791755. Acesso em: 5 out. 2025.
NITRINI, Ricardo et al. Revised criteria for diagnosis and staging of Alzheimer’s disease. Arquivos de Neuro-Psiquiatria, v. 82, n. 3, p. 215-224, 2024.
SALLOWAY, Stephen et al. TRAILBLAZER-ALZ 4: A phase 3 trial comparing donanemab with aducanumab on amyloid plaque clearance in early symptomatic Alzheimer’s disease. Alzheimer's & Dementia, 2025.
SELKOE, Dennis J.; HARDY, John. The amyloid hypothesis of Alzheimer’s disease at 25 years. EMBO Molecular Medicine, v. 8, p. 595-608, 2021.
SIMUFRANIL, H.; ANDERSEN, O.; KARRAN, E. Targeting amyloid-β in Alzheimer’s disease: therapeutic progress and challenges. Nature Reviews Neurology, v. 17, p. 557-575, 2021.
SNIDER, H. Literature review as a research methodology: an overview and guidelines. Journal of Business Research, v. 104, p. 333–339, nov. 2019. Disponível em: https://www.sciencedirect.com/science/article/pii/S0148296319304564 . Acesso em: 05 out. 2025.
SOUZA, M. T.; SILVA, M. D.; CARVALHO, R. Integrative review: what is it? How to do it? Einstein, São Paulo, v. 8, n. 1, p. 102–106, 2010. Disponível em: https://www.scielo.br/j/eins/a/ZQTBkVJZqcWrTT34cXLjtBx/?lang=en. Acesso em: 5 out. 2025.
SWANSON, Christian J. et al. A randomized, double-blind, phase 3 trial of lecanemab in early Alzheimer’s disease. New England Journal of Medicine, v. 388, p. 9-21, 2023.
VAN DYCK, Christopher H. et al. Lecanemab in early Alzheimer’s disease. New England Journal of Medicine, v. 388, p. 9-21, 2023.
YAGHMAEI, E. et al. Combined use of Donepezil and Memantine increases the probability of five-year survival of Alzheimer's disease patients. Communications Medicine, v. 4, n. 1, p. 99, 2024. DOI: https://doi.org/10.1038/s43856-024-00527-6
YAGHMAEI, Shirin et al. Monoclonal antibody therapies targeting amyloid-β in Alzheimer’s disease: clinical perspectives. Biomedicine & Pharmacotherapy, v. 171, 2024.
YANG, Chao et al. Efficacy and safety of anti-amyloid beta monoclonal antibodies in Alzheimer’s disease: a systematic review. Journal of Alzheimer’s Disease, v. 93, p. 789-804, 2024.