New era in Alzheimer's disease therapeutics: transitioning from symptomatic management to disease-modifying paradigms

doi:10.3969/j.issn.1672-6731.2026.02.002

Abstract

Abstract: The management of Alzheimer's disease(AD) is transitioning from symptomatic management to disease - modifying therapy(DMT). Conventional pharmacologic treatments provide only symptomatic relief and do not alter disease progression. Anti-amyloid β-protein(Aβ) monoclonal antibody drugs, exemplified by Lecanemab and Donanemab, have demonstrated efficacy in slowing cognitive decline in patients with early Alzheimer's disease. Improved access through insurance coverage and optimized dosing regimens has enhanced treatments availability; however, their use remains restricted to well-defined populations, mandating rigorous biomarker-based patient selection, and ongoing safety surveillance. Recent years have witnessed rapid advances in novel agents targeting tau pathology and neuroinflammation, as well as in technologies designed to enhance blood-brain barrier(BBB) penetration. Non-pharmacological interventions and immune cell-based therapies also show promising synergistic effects. Looking ahead,future strategies should focus on earlier intervention, promotion of precision medicine and combination therapies, and integration of multimodal approaches to transform Alzheimer's disease into a preventable and manageable disorder.

Key words: Alzheimer disease, Precision medicine, Biomarkers, Review

摘要： 阿尔茨海默病治疗正从对症干预向抗β-淀粉样蛋白（Aβ）疾病修饰治疗转变，以仑卡奈单抗、多奈单抗为代表的抗Aβ单克隆抗体药物可以延缓早期阿尔茨海默病患者的认知功能减退进程，医保准入与给药模式优化提升治疗的可及性，但适用人群有限，需要严格的生物学标志物分层与安全性监测。目前，靶向tau蛋白、神经炎症等新型药物及血脑屏障穿透技术快速发展，非药物干预、免疫细胞疗法等协同作用显著。未来需前移治疗窗口，推进精准与联合治疗，整合多元治疗策略，推动阿尔茨海默病向可防、可管模式转变。

关键词: 阿尔茨海默病, 精准医学, 生物标记, 综述

CLC Number:

R741

CHEN Xiao-chun, LIAO Jiang-feng. New era in Alzheimer's disease therapeutics: transitioning from symptomatic management to disease-modifying paradigms[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2026, 26(2): 109-111.

陈晓春, 廖江锋. 阿尔茨海默病治疗新纪元：从对症干预到疾病修饰范式转变[J]. 中国现代神经疾病杂志, 2026, 26(2): 109-111.

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URL: https://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2026.02.002

https://journal11.magtechjournal.com/cjcnn/EN/Y2026/V26/I2/109

References

[1] Fox NC, Belder C, Ballard C, Kales HC, Mummery C, Caramelli P, Ciccarelli O, Frederiksen KS, Gomez-Isla T, Ismail Z, Paquet C, Petersen RC, Perneczky R, Robinson L, Sayin O, Frisoni GB.Treatment for Alzheimer's disease[J]. Lancet, 2025, 406:1408-1423.
[2] Zhi N, Ren R, Qi J, Liu X, Yun Z, Lin S, Hu Y, Li H, Xie X, Wang J, Li J, Zhu Y, Gao M, Yang J, Wang Y, Jing Y, Geng J, Cao W, Xu Q, Yu X, Zhu Y, Zhou Y, Wang L, Gao C, Li B, Chen S, Yuan F, Dou R, Liu X, Li X, Yin Y, Chang Y, Xu G, Zhong Y, Li C, Wang Y, Zhou M, Wang G.The China Alzheimer report 2025[J]. Gen Psychiatr, 2025, 38:e102020.
[3] van Dyck CH, Swanson CJ, Aisen P, Bateman RJ, Chen C, Gee M, Kanekiyo M, Li D, Reyderman L, Cohen S, Froelich L, Katayama S, Sabbagh M, Vellas B, Watson D, Dhadda S, Irizarry M, Kramer LD, Iwatsubo T.Lecanemab in early Alzheimer's disease[J]. N Engl J Med, 2023, 388:9-21.
[4] Sims JR, Zimmer JA, Evans CD, Lu M, Ardayfio P, Sparks J, Wessels AM, Shcherbinin S, Wang H, Monkul Nery ES, Collins EC, Solomon P, Salloway S, Apostolova LG, Hansson O, Ritchie C, Brooks DA, Mintun M, Skovronsky DM;TRAILBLAZER-ALZ 2 Investigators.Donanemab in early symptomatic Alzheimer disease:the TRAILBLAZER-ALZ 2 randomized clinical tria[lJ]. JAMA, 2023, 330:512-527.
[5] Eisai Co., Ltd.FDA approves LEQEMBI^®IQLIKTM(lecanemab-irmb) subcutaneous injection for maintenance dosing for the treatment of early Alzheimer's disease[EB/OL]. (2025-08-30)[2025-11-23]. https://www.eisai.com/news/2025/news202559.html.
[6] Sato K, Iwatsubo T.Anti-amyloid antibody drugs as disease-modifying therapies for Alzheimer's disease[J]. Brain Nerve, 2024, 76:991-995.
[7] Eisai Co., Ltd.Anti-MTBR(microtubule binding region) Tau antibody etalanetug granted FDA fast track designation[EB/OL]. (2025-09-17)[2025-11-23]. https://www.eisai.com/news/2025/news202564.html.
[8] Kuntz L.October in review:updates on the psychiatric treatment pipeline[EB/OL]. (2025-10-31[)2025-11-23]. https://www.psychiatrictimes.com/view/october-in-review-updates-onthe-psychiatric-treatment-pipeline.
[9] Johnson&Johnson.Johnson&Johnson's Posdinemab and Tau active immunotherapy receive U.S.FDA fast track designations for the treatment of Alzheimer's disease[EB/OL]. (2025-01-08)[2025-11-23]. https://www.jnj.com/media-center/press-releases/johnson-johnsons-posdinemab-and-tau-active-immunotherapyreceive-u-s-fda-fast-track-designations-for-the-treatment-ofalzheimers-disease.
[10] Cummings JL, Burstein AH, Fillit H.Alzheimer combination therapies:overview and scenarios[J]. J Prev Alzheimers Dis, 2025, 12:100328.
[11] Chen SJ, Chen H, You J, Chen SD, Fu Y, Zhang W, Huang L, Feng JF, Gao X, Cheng W, Yuan C, Yu JT.Machine learning-assisted optimization of dietary intervention against dementia risk[J]. Nat Hum Behav, 2025, 9:2313-2326.
[12] Rash BG, Ramdas KN, Agafonova N, Naioti E, McClain-Moss L, Zainul Z, Varnado B, Peterson K, Brown M, Leal T, Kopcho S, Carballosa R, Patel P, Brody M, Herskowitz B, Fuquay A, Rodriguez S, Jacobson AF, Leon R, Pfeffer M, Schwartzbard JB, Botbyl J, Oliva AA Jr, Hare JM.Allogeneic mesenchymal stem cell therapy with laromestrocel in mild Alzheimer's disease:a randomized controlled phase 2a trial[J]. Nat Med, 2025, 31:1257-1266.
[13] Elyaman W, Stern LJ, Jiang N, Dressman D, Bradley P, Klatzmann D, Bradshaw EM, Farber DL, Kent SC, Chizari S, Funk K, Devanand D, Thakur KT, Raj T, Dalahmah OA, Sarkis RA, Weiner HL, Shneider NA, Przedborski S.Exploring the role of T cells in Alzheimer's and other neurodegenerative diseases:emerging therapeutic insights from the T cells in the brain symposium[J]. Alzheimers Dement, 2025, 21:e14548.
[14] Murdock MH, Yang CY, Sun N, Pao PC, Blanco-Duque C, Kahn MC, Kim T, Lavoie NS, Victor MB, Islam MR, Galiana F, Leary N, Wang S, Bubnys A, Ma E, Akay LA, Sneve M, Qian Y, Lai C, McCarthy MM, Kopell N, Kellis M, Piatkevich KD, Boyden ES, Tsai LH.Multisensory gamma stimulation promotes glymphatic clearance of amyloid[J]. Nature, 2024, 627:149-156.
[15] Li X, Zhang Y, Tang L, Ye L, Tang M.Effects of virtual reality-based interventions on cognitive function, emotional state, and quality of life in patients with mild cognitive impairment:a meta-analysis[J]. Front Neurol, 2025, 16:1496382.

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