Point of view: Challenges in implementation of new immunotherapies for Alzheimer's disease
The advancement of disease-modifying treatments (DMTs) for Alzheimer's disease (AD), along with the approval of three amyloid-targeting therapies in the US and several other countries, represents a significant development in the treatment landscape, offering new hope for addressing this once untreatable chronic progressive disease. However, significant challenges persist that could impede the successful integration of this class of drugs into clinical practice. These challenges include determining patient eligibility, appropriate use of diagnostic tools and genetic testing in patient care pathways, effective detection and monitoring of side effects, and improving the healthcare system's readiness by engaging both primary care and dementia specialists. Additionally, there are logistical concerns related to infrastructure, as well as cost-effectiveness and reimbursement issues. This article brings together insights from a diverse group of international researchers and dementia experts and outlines the potential challenges and opportunities, urging all stakeholders to prepare for the introduction of DMTs. We emphasize the need to develop appropriate use criteria, including patient characteristics, specifically for the European healthcare system, to ensure that treatments are administered to the most suitable patients. It is crucial to improve the skills and knowledge of physicians to accurately interpret biomarker results, share decision-making with patients, recognize treatment-related side effects, and monitor long-term treatment. We advocate for investment in patient registries and unbiased follow-up studies to better understand treatment effectiveness, evaluate treatment-related side effects, and optimize long-term treatment. Utilizing amyloid-targeting therapies as a starting point for combination therapies should also be a priority.
Authors
- Linus Jönsson (ORCID: https://orcid.org/0000-0001-5751-6292)
- Caroline Graff (ORCID: https://orcid.org/0000-0002-9949-2951)
- Lars Lannfelt (ORCID: https://orcid.org/0000-0001-9839-659X)
- Sebastian Palmqvist (ORCID: https://orcid.org/0000-0002-9267-1930)
- Kaj Blennow (ORCID: https://orcid.org/0000-0002-1890-4193)
- Philip Scheltens (ORCID: https://orcid.org/0000-0002-1046-6408)
- José Luís Molinuevo (ORCID: https://orcid.org/0000-0003-0485-6001)
- Sandar Aye (ORCID: https://orcid.org/0000-0003-1360-4834)
- Kristian Steen Frederiksen (ORCID: https://orcid.org/0000-0001-5124-4417)
- Lutz Froelich (ORCID: https://orcid.org/0000-0003-1494-0813)
- Gunilla Johansson (ORCID: https://orcid.org/0000-0003-1367-2247)
- Norbert Žilka (ORCID: https://orcid.org/0000-0003-2397-2083)
- Michael Schöll (ORCID: https://orcid.org/0000-0001-7800-1781)
- Martin Tolar (ORCID: https://orcid.org/0000-0002-3910-091X)
- Bengt Winblad (ORCID: https://orcid.org/0000-0002-0011-1179)
- Ron L. H. Handels (ORCID: https://orcid.org/0000-0002-8663-0630)
- Anders Wimo (ORCID: https://orcid.org/0000-0003-0963-5750)
- Peter Johannsen (ORCID: https://orcid.org/0000-0003-4570-8881)
- Miia Kivipelto (ORCID: https://orcid.org/0009-0001-1069-1787)
- John R. Sims
- Christoph Höck
Institutions
- Karolinska University Hospital (SE)
- Lundbeck (Denmark) (DK)
- Eli Lilly (United States) (US)
- Novo Nordisk (Denmark) (DK)
- Heidelberg University (DE)
- Sahlgrenska University Hospital (SE)
- University Hospital Heidelberg (DE)
- Copenhagen University Hospital (DK)
- Karolinska Institutet (SE)
- Maastricht University (NL)
- Sorbonne Université (FR)
- Central Institute of Mental Health (DE)
- Lundbeck (Spain) (ES)
- Dementia UK (GB)
- Neurotune (Switzerland) (CH)
- Skåne University Hospital (SE)
- BioArctic Neuroscience (Sweden) (SE)
- Institut du Cerveau (FR)
- AXON Neuroscience (Slovakia) (SK)
- University College London (GB)
- Framingham State University (US)
- University of Gothenburg (SE)
Publication Details
- Journal
- The Journal of Prevention of Alzheimer s Disease
- Published
- 2025-01-01
- DOI
- https://doi.org/10.1016/j.tjpad.2024.100022
- Citations
- 8
- Primary Topic
- Alzheimer's disease research and treatments
- Type
- article
- Field-Weighted Citation Impact
- 9.31
Funders
- Alzheimer's Association
- Alzheimer's Drug Discovery Foundation
- Eli Lilly and Company
- EU Joint Programme – Neurodegenerative Disease Research
- European Commission
- Eisai
- Hjärnfonden
- Vetenskapsrådet
- NordForsk
- Forskningsrådet om Hälsa, Arbetsliv och Välfärd
- Alzheimerfonden
- Fondation pour la Recherche sur Alzheimer
- Center for Innovative Medicine