Comparative analysis of FDA-approved Alzheimer’s therapies: symptomatic and disease-modifying approaches

Khaled M. A. Q. R., YAVUZ A. N.

Journal of Research in Pharmacy, vol.29, no.5, pp.2165-2179, 2025 (ESCI, Scopus, TRDizin) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 29 Issue: 5
  • Publication Date: 2025
  • Doi Number: 10.12991/jrespharm.1707084
  • Journal Name: Journal of Research in Pharmacy
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.2165-2179
  • Keywords: acetylcholinesterase inhibitors, Alzheimer’s disease, amyloid-beta, disease-modifying therapy, monoclonal antibodies, N-methyl-d-aspartate receptor antagonists, symptomatic therapy, tau pathology
  • Marmara University Affiliated: Yes

Abstract

Alzheimer's disease (AD) is a progressive neurodegenerative disorder primarily affecting the elderly and the most common cause of dementia, characterized by neuronal loss, cognitive decline, and memory impairment. Several FDA-approved medications for AD fall into two main categories: symptomatic treatments and disease-modifying therapies. Symptomatic treatments include acetylcholinesterase inhibitors and N-methyl-d-aspartate (NMDA) receptor antagonists. These drugs help mitigate cognitive decline: cholinesterase inhibitors increase acetylcholine levels, whereas NMDA receptor antagonists regulate glutamate activity. Disease-modifying therapies treat the disease pathology by reducing the amyloid-beta plaque burden. These are monoclonal antibody therapies such as Aducanumab, Lecanemab, and Donanemab, the latter as a monthly intravenous infusion until the plaques can no longer be detected. This review provides a comparative analysis of symptomatic and disease-modifying therapies, focusing on their pharmacokinetics, characteristics, mechanisms of action, clinical efficacy, side effects, and recent trial findings.