https://scholars.lib.ntu.edu.tw/handle/123456789/519896
標題: | Combotherapy and current concepts as well as future strategies for the treatment of Alzheimer's disease | 作者: | Fan L.-Y. MING-JANG CHIU |
公開日期: | 2014 | 卷: | 10 | 起(迄)頁: | 439-451 | 來源出版物: | Neuropsychiatric Disease and Treatment | 摘要: | It has been estimated that 35.6 million people globally had dementia in 2010 and the prevalence of dementia has been predicted to double every 20 years. Thus, 115.4 million people may be living with dementia in 2050. Alzheimer's disease (AD) is the leading cause of dementia and is present in 60%-70% of people with dementia. Unfortunately, there are few approved drugs that can alleviate the cognitive or behavioral symptoms of AD dementia. Recent studies have revealed that pathophysiological changes related to AD occur decades before the appearance of clinical symptoms of dementia. This extended preclinical phase of AD provides a critical chance for disease-modifying agents to halt or delay the relentless process of AD. Although several trials targeting various pathological processes are ongoing, the examination of the combined use of different approaches to combat AD seems warranted. In this article, we will review current therapies, future strategies, and ongoing clinical trials for the treatment of AD with a special focus on combination therapies. Furthermore, preventive strategies for cognitively normal subjects in the presymptomatic stages of AD will also be addressed. In this review, we discuss current hypotheses of the disease process. In the decades since the approval of cholinesterase inhibitors, no new drug has ultimately demonstrated clear success in clinical trials. Given the difficulties that have been encountered in attempts to identify a single drug that can treat AD, we must pursue effective multi-target strategies, ie, combination therapies. The combination of cholinesterase inhibitors and memantine is considered well tolerated and safe, and this combination benefits patients with moderate-to-severe AD. In contrast, with the exception of adjuvant therapies of conventional drugs, combinations of different disease-modifying agents with different mechanisms may have promising synergic effects and benefit cognition, behavior, and daily living function. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84897900177&doi=10.2147%2fNDT.S45143&partnerID=40&md5=c62f2bb245dbe577e5b9e7ecd0041fd7 https://scholars.lib.ntu.edu.tw/handle/123456789/519896 |
ISSN: | 1176-6328 | DOI: | 10.2147/NDT.S45143 | SDG/關鍵字: | 2,4 thiazolidinedione derivative; antioxidant; cerebrolysin; cholinesterase inhibitor; crenezumab; dimebon; donepezil; memantine; methylene blue; nerve growth factor; phosphodiesterase inhibitor; rember; serotonin 6 antagonist; solanezumab; tau protein; unclassified drug; Alzheimer disease; amyloid neuropathy; asymptomatic disease; clinical trial (topic); cognitive therapy; combination chemotherapy; drug efficacy; drug safety; drug targeting; drug tolerability; human; neuropathology; nonhuman; outcome assessment; practice guideline; preventive medicine; review; risk benefit analysis; transcranial magnetic stimulation; treatment response |
顯示於: | 醫學系 |
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