Aducanumab

Abstract

Introduction and Definition: Aducanumab is “a human monoclonal antibody that selectively targets aggregated Aβ [amyloid-beta protein]”. This has been used as a novel therapy for treating Alzheimer’s disease (AD), as AD is characterized by an accumulation of amyloid plaques in the brain, which are proposed to lead to the cognitive decline attributed to this disease. Millions of people are impacted by this disease worldwide, highlighting its importance for research. Aducanumab was the first drug designed to bind to Aβ plaques in the brain and was approved by the U.S. Federal Drug Administration (FDA) in 2021 for treatment of AD.

Body: By binding to Aβ, aducanumab triggers microglia to phagocytose the fibrils and plaques created by the aggregation of Aβ, reducing the neuroinflammatory effects often seen in AD. Aducanumab has the highest affinity for amyloid oligomers and fibrils, which are the most detrimental structures when accumulated. Not only does aducanumab function by removing Aβ plaques, but it may also reduce neuroinflammatory cytokine production and decrease the rate of astrogliosis, both of which fluctuate depending on levels of Aβ. Patients in early or middle stages of AD, and who have been screened for Aβ levels via amyloid positron emission tomography (PET) scans, can be prescribed aducanumab by their healthcare providers. Aducanumab is administered once every month intravenously, at a dose of 10 mg/kg of body weight. Despite its ability to target and breakdown Aβ oligopeptide aggregates, significant positive effects on cognitive decline have not yet been proven. High doses of aducanumab were found to have moderate effects only in patients with early onset AD and did not show improvements for prior memory loss. Further, aducanumab treatment has been linked with amyloid-related imaging abnormalities (ARIA), a group of neurological harmful effects comprised of two main subdivisions of edema and microhemorrhages. Other pharmacological drugs are being formulated to target Aβ in a more specific manner than aducanumab, such as lecanemab. Additionally, research is further investigating the effects of holistic treatment interventions, like maintaining good physical health, on the progression of AD.