Pharmacological strategies for managing dementia with Lewy bodies: an expert review of symptom-targeted care.

IF 3 3区医学 Q2 PHARMACOLOGY & PHARMACY

Expert Review of Clinical Pharmacology Pub Date : 2025-09-19 DOI:10.1080/17512433.2025.2562151

Oluwatosin Atewogboye, John Paul Taylor, Judith R Harrison

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引用次数: 0

Abstract

Introduction: Dementia with Lewy Bodies (DLB) is the second most common cause of neurodegenerative dementia after Alzheimer's disease, characterized by a complex combination of cognitive, neuropsychiatric, motor, autonomic, and sleep-related symptoms. Symptom fluctuation, polypharmacy risks, and high sensitivity to commonly used drugs present unique challenges for management.

Areas covered: This review provides a comprehensive overview of the symptomatic management of DLB, organized by clinical domains. It critically evaluates current pharmacological and non-pharmacological treatment strategies for cognitive impairment, hallucinations, parkinsonism, autonomic dysfunction, and sleep disturbances. Evidence is drawn from clinical trials, meta-analyses, and extrapolated findings from related disorders such as Alzheimer's disease and Parkinson's disease.

Expert opinion: Effective DLB management requires an individualized, symptom-prioritized approach that carefully balances therapeutic benefit with potential adverse effects, particularly given the high risk of antipsychotic sensitivity and treatment-induced worsening of symptoms. Despite recent progress, evidence remains sparse for many symptom domains. Greater investment in DLB-specific clinical trials and development of targeted therapies is urgently needed to improve patient outcomes.

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治疗路易体痴呆的药理学策略：症状靶向治疗的专家综述。

导语：路易体痴呆（DLB）是继阿尔茨海默病之后导致神经退行性痴呆的第二大常见原因，其特征是认知、神经精神、运动、自主神经和睡眠相关症状的复杂组合。症状波动、多药风险和对常用药物的高敏感性给其管理带来了独特的挑战。涵盖领域：本综述提供了DLB症状管理的全面概述，按临床领域组织。它批判性地评估了当前认知障碍、幻觉、帕金森症、自主神经功能障碍和睡眠障碍的药物和非药物治疗策略。证据来自临床试验、荟萃分析和相关疾病（如阿尔茨海默病和帕金森病）的外推结果。专家意见：有效的DLB管理需要个体化、症状优先的方法，仔细平衡治疗益处和潜在的不良反应，特别是考虑到抗精神病药物敏感性和治疗引起的症状恶化的高风险。尽管最近取得了进展，但许多症状领域的证据仍然很少。迫切需要加大对dlb特异性临床试验和靶向治疗开发的投资，以改善患者的治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Clinical Pharmacology PHARMACOLOGY & PHARMACY-

CiteScore

7.30

自引率

2.30%

发文量

127

期刊介绍： Advances in drug development technologies are yielding innovative new therapies, from potentially lifesaving medicines to lifestyle products. In recent years, however, the cost of developing new drugs has soared, and concerns over drug resistance and pharmacoeconomics have come to the fore. Adverse reactions experienced at the clinical trial level serve as a constant reminder of the importance of rigorous safety and toxicity testing. Furthermore the advent of pharmacogenomics and ‘individualized’ approaches to therapy will demand a fresh approach to drug evaluation and healthcare delivery. Clinical Pharmacology provides an essential role in integrating the expertise of all of the specialists and players who are active in meeting such challenges in modern biomedical practice.