Eficacia de los anticuerpos monoclonales anti-beta amiloide para el deterioro cognitivo en pacientes con Alzheimer: revisión sistemática

Abstract

Background: Alzheimer’s Disease (AD) is the leading cause of dementia worldwide and affects more than 44 million people. Its incidence increases with age. AD generates significant economic and social burdens, and traditional treatments have limited efficacy. Objective: To compare the efficacy of anti-beta amyloid monoclonal antibodies for cognitive impairment in patients with Alzheimer’s disease. Methods: Systematic review of descriptive, comparative, and qualitative designs based on PRISMA 2020 guidelines. The databases used were PubMed, Scopus, ScienceDirect, and Springer Link. Results: Fourteen randomized clinical trials involving 13,905 patients were included. Conclusions: Monoclonal antibodies are indicated in the early stages of Alzheimer’s disease and are not considered first-line treatment. Their benefit is to slow cognitive decline by reducing cerebral amyloid burden; however, the risks of developing amyloid-related imaging abnormalities (ARIA) are very high. Lecanemab and donanemab demonstrated better performance in reducing amyloid burden and decelerating cognitive decline compared to aducanumab, gantenerumab, and solanezumab, as evidenced by the ADAS-COG, CDR-SB, and ADCOMS scales, which assess cognitive decline. Keywords: Alzheimer’s disease, anti-beta amyloid (Aβ), monoclonal antibody