{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T16:57:17Z","timestamp":1788195437007,"version":"build-2803163510"},"reference-count":242,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T00:00:00Z","timestamp":1660780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Since 1906, when Dr. Alois Alzheimer first described in a patient \u201ca peculiar severe disease process of the cerebral cortex\u201d, people suffering from this pathology have been waiting for a breakthrough therapy. Alzheimer\u2019s disease (AD) is an irreversible, progressive neurodegenerative brain disorder and the most common form of dementia in the elderly with a long presymptomatic phase. Worldwide, approximately 50 million people are living with dementia, with AD comprising 60\u201370% of cases. Pathologically, AD is characterized by the deposition of amyloid \u03b2-peptide (A\u03b2) in the neuropil (neuritic plaques) and blood vessels (amyloid angiopathy), and by the accumulation of hyperphosphorylated tau in neurons (neurofibrillary tangles) in the brain, with associated loss of synapses and neurons, together with glial activation, and neuroinflammation, resulting in cognitive deficits and eventually dementia. The current competitive landscape in AD consists of symptomatic treatments, of which there are currently six approved medications: three AChEIs (donepezil, rivastigmine, and galantamine), one NMDA-R antagonist (memantine), one combination therapy (memantine\/donepezil), and GV-971 (sodium oligomannate, a mixture of oligosaccharides derived from algae) only approved in China. Improvements to the approved therapies, such as easier routes of administration and reduced dosing frequencies, along with the developments of new strategies and combined treatments are expected to occur within the next decade and will positively impact the way the disease is managed. Recently, Aducanumab, the first disease-modifying therapy (DMT) has been approved for AD, and several DMTs are in advanced stages of clinical development or regulatory review. Small molecules, mAbs, or multimodal strategies showing promise in animal studies have not confirmed that promise in the clinic (where small to moderate changes in clinical efficacy have been observed), and therefore, there is a significant unmet need for a better understanding of the AD pathogenesis and the exploration of alternative etiologies and therapeutic effective disease-modifying therapies strategies for AD. Therefore, a critical review of the disease-modifying therapy pipeline for Alzheimer\u2019s disease is needed.<\/jats:p>","DOI":"10.3390\/ijms23169305","type":"journal-article","created":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T21:39:21Z","timestamp":1660858761000},"page":"9305","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Symptomatic and Disease-Modifying Therapy Pipeline for Alzheimer\u2019s Disease: Towards a Personalized Polypharmacology Patient-Centered Approach"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3012-2864","authenticated-orcid":false,"given":"Xavier","family":"Morat\u00f3","sequence":"first","affiliation":[{"name":"Research Center and Memory Clinic, Fundaci\u00f3 ACE, Institut Catal\u00e0 de Neuroci\u00e8ncies Aplicades, Universitat Internacional de Catalunya, 08017 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanesa","family":"Pytel","sequence":"additional","affiliation":[{"name":"Research Center and Memory Clinic, Fundaci\u00f3 ACE, Institut Catal\u00e0 de Neuroci\u00e8ncies Aplicades, Universitat Internacional de Catalunya, 08017 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Jofresa","sequence":"additional","affiliation":[{"name":"Research Center and Memory Clinic, Fundaci\u00f3 ACE, Institut Catal\u00e0 de Neuroci\u00e8ncies Aplicades, Universitat Internacional de Catalunya, 08017 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2633-2495","authenticated-orcid":false,"given":"Agust\u00edn","family":"Ruiz","sequence":"additional","affiliation":[{"name":"Research Center and Memory Clinic, Fundaci\u00f3 ACE, Institut Catal\u00e0 de Neuroci\u00e8ncies Aplicades, Universitat Internacional de Catalunya, 08017 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merc\u00e8","family":"Boada","sequence":"additional","affiliation":[{"name":"Research Center and Memory Clinic, Fundaci\u00f3 ACE, Institut Catal\u00e0 de Neuroci\u00e8ncies Aplicades, Universitat Internacional de Catalunya, 08017 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1016\/S0140-6736(20)32205-4","article-title":"Alzheimer\u2019 s disease","volume":"397","author":"Scheltens","year":"2021","journal-title":"Lancet"},{"key":"ref_2","unstructured":"GBD 2019 Dementia Forecasting Collaborators (2022). 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