Drugs used in the treatment of Alzheimer’s disease: a review of current clinical research and promising therapeutic targets

Medications used in Alzheimer’s disease are currently aimed primarily at eliminating the symptoms of the disease, while more modern drugs based on monoclonal antibodies are still of limited use. In this work, an analysis of drugs for the treatment of Alzheimer’s disease was carried out, including a review of clinical trials and drugs used in clinical practice. Results and discussion . The main approaches to therapy are analyzed: drugs for basic therapy (cholinesterase inhibitors, memantine) and new drugs based on monoclonal antibodies (lecanemab, donanemab) aimed at beta-amyloid, which demonstrate the ability to slow cognitive decline in the early stages of the disease, but are associated with the risk of amyloid-related imaging abnormalities (ARIA). Promising areas are also considered: tau protein-targeted therapy, the use of glucagon-like peptide 1 receptor agonists (semaglutide), neuroinflammation modulation (interleukin-2), and gene therapy. It was revealed that the majority of clinical trials (208 in phase I‒III) are focused on anti-amyloid drugs and reducing the accumulation of tau proteins in the brain. Conclusions. The development of drugs is shifting from symptomatic to pathogenetic therapy. Despite the appearance of anti-amyloid antibodies, their use is limited by risks and high cost. Promising areas of therapy are the development of bispecific antibodies, combination therapy connecting several mechanisms, as well as gene therapy.