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Use of monoclonal antibodies in Alzheimer’s disease - a systematic review of phase III clinical trials

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Alzheimer's disease (AD) is an irreversible neurodegenerative disorder and the most prevalent form of dementia worldwide (1). It is characterized by progressive cognitive decline, memory loss, and neuropsychiatric symptoms, significantly impacting patients' quality of life and imposing a substantial burden on caregivers and healthcare systems (1). Current pharmacological treatments available in Portugal include cholinesterase inhibitors: Rivastigmine, Galantamine, Donepezil, and the N-methyl-D-aspartate (NMDA) receptor antagonist Memantine (2). These drugs primarily offer symptomatic relief by modulating neurotransmitter activity but fail to halt or reverse disease progression. Given the limited efficacy of these therapies, there has been a paradigm shift towards disease-modifying treatments, particularly those targeting the key pathological hallmarks of AD—amyloid beta (Aβ) plaques and Tau protein aggregation (2). In recent years, immunotherapy has emerged as a promising strategy in AD research, particularly through the development of monoclonal antibodies (mAbs) designed to target and clear amyloid beta aggregates (4). Several mAbs have been investigated in late-stage clinical trials, with varying degrees of success.

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Reis, J., Moreira, F., & Santos, M. (2026). Use of monoclonal antibodies in Alzheimer’s disease—A systematic review of phase III clinical trials. Abstracts of the 38th ECNP Congress 2025 -Neuroscience Applied, 5, 105976. https://doi.org/10.1016/j.nsa.2025.105976

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