USE OF MONOCLONAL ANTIBODIES IN THE TREATMENT OF ALZHEIMER'S DISEASE: LITERATURE REVIEW

• DOI: https://doi.org/10.22533/at.ed.1595352524122

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• Abstract:

  Introduction: Alzheimer's disease is a progressive neurodegenerative condition characterized by cognitive decline, functional impairment, and beta-amyloid accumulation in the brain. In recent decades, disease-modifying therapies aimed at amyloid removal have gained prominence, particularly monoclonal antibodies developed to slow the clinical progression of the disease. Recent studies, including narrative reviews, systematic reviews, and meta-analyses, have evaluated the efficacy, safety, and applicability of molecules such as aducanumab, lecanemab, and donanemab, seeking to understand whether reducing amyloid burden translates into significant clinical benefits and what the real impact of these treatments is in practice. Method: This study is a narrative review that analyzed the literature on the use of monoclonal antibodies in the treatment of Alzheimer's disease. Articles were selected from the BIREME, PubMed, and Cochrane databases using the keywords "monoclonal antibodies," "treatment," and "Alzheimer's." Inclusion criteria covered articles in English and Portuguese published in the last five years. Studies with unclear methodology or irrelevant to the topic were excluded. A total of five articles were selected and analyzed. Results and Discussion: The literature reviewed consistently demonstrates that anti-amyloid monoclonal antibodies can significantly reduce beta-amyloid deposition detected by imaging techniques, with modest but statistically significant effects on slowing cognitive and functional decline. Lecanemab and donanemab show the most robust results, with more reproducible benefits across studies, while aducanumab shows more limited and controversial efficacy. Despite these advances, the clinical effects remain modest and more evident in the early stages of the disease, which limits the universal applicability of these treatments. At the same time, the harms are considerable: events such as ARIA
  — which can range from asymptomatic findings to severe neurological complications — are frequent and require intensive monitoring. Conclusion: Monoclonal antibodies are a significant advance in the search for therapies
   
  modifying therapies for Alzheimer's disease, offering measurable clinical benefits and supporting the amyloid hypothesis. However, their effects remain modest, limited mainly to the early stages of the disease, and accompanied by significant risks and practical challenges that hinder their widespread adoption. The literature converges on the idea that, although promising, these treatments do not represent a definitive solution and should be seen as part of a broader therapeutic approach.