阿茲海默症 (Alzheimer’s disease, AD) 為一種不可逆、進行性的神經退化性疾 病，以認知和行為障礙為主要特徵，是目前最常見的失智症形式，在病人的腦中，會 出現不正常的澱粉樣斑塊與神經纖維糾結，導致過度發炎，造成神經細胞壞死。目前 治療藥物以乙醯膽鹼酯酶抑制劑 (acetylcholinesterase inhibitor) 及非競爭性 NMDA (N-methyl-D-aspartate) 受體拮抗劑兩大類，可改善認知功能，減緩病程的進展，卻不能達到治癒目標。Aducanumab 為美國食品藥物管理局於2021年6月核准用於 AD 引起的輕度認知障礙及早期失智症，可直接針對聚集的 β 型澱粉樣蛋白，減少澱粉樣蛋白斑塊堆積，本文綜參目前AD藥物治療之相關臨床研究，提供臨床用藥參考。

 

Alzheimer’s disease (AD) is the most frequent cause of dementia and is an irreversible neurological condition characterized by cognitive and behavioral problems. The aberrant amyloid plaques and neurofibrillary tangles in the brains of AD patients cause excessive inflammation and nerve cell death. The medications currently prescribed for therapy include acetylcholinesterase inhibitors and noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonists, both of which can enhance cognitive function and delay disease development but do not cure the disorder. The US Food and Drug Administration authorized aducanumab in June 2021 for the treatment of moderate cognitive impairment and early dementia caused by AD. It can target aggregated forms of beta-amyloid and decrease the number of amyloid beta plaques. This article summarizes the findings of the current clinical research on AD therapy and provides a reference for clinical practice.

 

Submited for publication: 2021.12.20; Accepted for publication: 2022.3.26