Abstract

FERREIRA, Sofia  and  MASSANO, João. Pharmacological therapy in Alzheimer’s disease: progress and future hopes. Arq Med [online]. 2013, vol.27, n.2, pp.65-86. ISSN 2183-2447.

It is estimated that over 24 million people suffer from dementia worldwide; in Portugal more than 150000 people are affected, and 90000 of these have Alzheimer’s disease (AD). Considering the aging of the population and increasing life expectancy, as well as the deleterious impact of the disease, it becomes essential to obtain a disease-modifying treatment or, ideally, preventive. However, this is not the current reality. The aim of this manuscript is to review the progresses achieved so far with regard to pharmacological therapies in AD, particularly those with potential disease modifying effect, as well as drugs under development. A literature search has been performed, supplemented by analysis of clinical trials registered in the website clinicaltrials.gov. Several clinical trials have been developed to determine the effectiveness of new drugs in the treatment of AD. There are different drugs with different mechanisms of action. The initial excitement, especially regarding drugs which influence the amyloidogenic pathway, has faded, since many clinical trials have shown disappointing results (such as the cases of semagacestat, tarenflurbil, tramiprosate, valproate, phenserine and dimebon). Thus, new agents are under investigation (PBT2, passive immunization, davunetide, methylene blue, huperzine A, neurotrophins, intranasal insulin, among others). The lack of agreement between results observed in animal models and those seen in clinical trials may be due to methodological shortcomings or to the still insufficient knowledge concerning the pathophysiology of the disease.

Keywords : Alzheimer’s disease; dementia; disease-modifying therapy; treatment; pharmacotherapy.

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