阿尔茨海默病Aβ免疫治疗的临床获益OA

The deposition of β-amyloid(Aβ)in the brain is a key step in the pathogenesis of Alzheimer's disease(AD).The clearance of Aβ using anti-Aβ monoclonal antibodies is the most important disease modification therapy(DMT)for AD.Lecanemab and Donanemab are currently two approved anti-Aβ antibodies.This article systematically reviews the results of phase Ⅲ clinical trials for these two drugs,with a particular focus on the changes in biomarkers(amyloid PET-CT and cerebrospinal fluid or plasma biomarkers)during treatment,as well as efficacy evaluation.It summarizes the heterogeneity of clinical efficacy among different patients and its possible influencing factors.Combined with preliminary follow-up data from real-world studies in Northwest China,the review systematically summarizes the clinical benefits of targeted Aβ monoclonal antibodies as DMT for AD.It proposes the adoption of a new concept"meaningful benefit"for evaluation,emphasizing that the goal of DMT for AD is not short-term symptom improvement,but the cumulative effect of long-term treatment.Specifically,the longer the treatment duration,the more pronounced the effect in delaying cognitive and functional decline,thereby postponing the time when patients progress to more severe stages of the disease.This provides important evidence for clinicians in treatment decision-making,efficacy evaluation,and patient management.