精神医学64巻6号

2022年06月発行

特集 認知症診療の新潮流—近未来の認知症診療に向けて

アルツハイマー病に対する疾患修飾薬の現状と期待

著者： 布村明彦¹

所属機関： ¹東京慈恵会医科大学附属第三病院精神神経科

ページ範囲：P.849 - P.857

抄録　アルツハイマー病(AD)の疾患修飾療法確立に向け，脳の蓄積蛋白質であるアミロイドβ(Aβ)やタウを標的にした薬剤の開発が進んでいる。昨年，抗Aβ抗体アデュカヌマブが米国食品医薬品局(FDA)によって，ADによる軽度認知障害(MCI due to AD)ならびに軽度ADに対して迅速承認された(わが国では継続審議中)。さらにFDAがブレイクスルー治療薬に指定したドナネマブやレカネマブなどの開発も有望視されている。
　他方，多元的な治療標的の探索も行われ，現在治験中のAD疾患修飾薬候補のうちAβやタウ以外を標的とする薬剤が約7割を占める。その標的には，炎症・免疫，シナプス可塑性，代謝・生体エネルギー，蛋白質恒常性，血管系要因などが挙げられる。
　今後もAβやタウ標的薬を中心に有効性と安全性が追究され，これらに多元標的療法も組み合わされ，近い将来にAD疾患修飾療法が確立されることが期待される。

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