{"title":"抗淀粉样蛋白治疗痴呆症：担忧大于希望。","authors":"Leon Flicker","doi":"10.1097/YCO.0000000000001021","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>To review the association between Alzheimer pathology and dementia and the role of mAbs targeting amyloid in the treatment of people with dementia and mild cognitive impairment.</p><p><strong>Recent findings: </strong>There is an association, but Alzheimer pathology explains less than 40% of the attributable risk of dementia when other pathologies such as vascular, Lewy Body and TDP-43 are accounted. Recent trials of passive immunization with MABs, including Aducanumab Lecanemab and Donanemab, have demonstrated some benefits but the effects are small in size and may be due to bias. The side effect of amyloid-related imaging abnormalities (ARIA) is common and potentially serious. The costs of assessments for treatment and actual treatment costs are large compared with potentially modest benefits.</p><p><strong>Summary: </strong>It is still uncertain about the place of MABs in the treatment of Alzheimer's dementia. Further research is required regarding the long-term benefits and risks.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"355-360"},"PeriodicalIF":4.9000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Antiamyloid treatment for dementia: concerns outweigh hopes.\",\"authors\":\"Leon Flicker\",\"doi\":\"10.1097/YCO.0000000000001021\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose of review: </strong>To review the association between Alzheimer pathology and dementia and the role of mAbs targeting amyloid in the treatment of people with dementia and mild cognitive impairment.</p><p><strong>Recent findings: </strong>There is an association, but Alzheimer pathology explains less than 40% of the attributable risk of dementia when other pathologies such as vascular, Lewy Body and TDP-43 are accounted. Recent trials of passive immunization with MABs, including Aducanumab Lecanemab and Donanemab, have demonstrated some benefits but the effects are small in size and may be due to bias. The side effect of amyloid-related imaging abnormalities (ARIA) is common and potentially serious. The costs of assessments for treatment and actual treatment costs are large compared with potentially modest benefits.</p><p><strong>Summary: </strong>It is still uncertain about the place of MABs in the treatment of Alzheimer's dementia. Further research is required regarding the long-term benefits and risks.</p>\",\"PeriodicalId\":11022,\"journal\":{\"name\":\"Current Opinion in Psychiatry\",\"volume\":\" \",\"pages\":\"355-360\"},\"PeriodicalIF\":4.9000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Opinion in Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/YCO.0000000000001021\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/9 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Opinion in Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/YCO.0000000000001021","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/9 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Antiamyloid treatment for dementia: concerns outweigh hopes.
Purpose of review: To review the association between Alzheimer pathology and dementia and the role of mAbs targeting amyloid in the treatment of people with dementia and mild cognitive impairment.
Recent findings: There is an association, but Alzheimer pathology explains less than 40% of the attributable risk of dementia when other pathologies such as vascular, Lewy Body and TDP-43 are accounted. Recent trials of passive immunization with MABs, including Aducanumab Lecanemab and Donanemab, have demonstrated some benefits but the effects are small in size and may be due to bias. The side effect of amyloid-related imaging abnormalities (ARIA) is common and potentially serious. The costs of assessments for treatment and actual treatment costs are large compared with potentially modest benefits.
Summary: It is still uncertain about the place of MABs in the treatment of Alzheimer's dementia. Further research is required regarding the long-term benefits and risks.
期刊介绍：
Current Opinion in Psychiatry is an easy-to-digest bimonthly journal covering the most interesting and important advances in the field of psychiatry. Eight sections on mental health disorders including schizophrenia, neurodevelopmental disorders and eating disorders, are presented alongside five area-specific sections, offering an expert evaluation on the most exciting developments in the field.
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