Importance of the field
Alzheimer’s disease is the leading cause of dementia in the elderly, and there is no disease-modifying therapy yet available. Immunotherapy directed against the β-amyloid peptide may be capable of slowing the rate of disease progression. Bapineuzumab, an anti–β-amyloid monoclonal antibody, will be the first such agent to emerge from Phase III clinical trials.
Areas covered in this review
The primary literature on bapineuzumab from 2009–2010 is reviewed in its entirety, along with the literature on AN1792, a first-generation anti–β-amyloid vaccine, from 2003–2009. Other Alzheimer’s disease immunotherapeutics currently in development, according to www.clinicaltrials.gov, are also discussed.
What the reader will gain
In addition to a critical appraisal of the Phase II trial results for bapineuzumab, this review considers the broader field of immunotherapy for Alzheimer’s disease as a whole, including the challenges ahead.
Take home message
Bapineuzumab appears capable of reducing the cerebral β-amyloid peptide burden in patients with Alzheimer’s disease. However, particularly in APOE ε4 carriers, its ability to slow disease progression remains uncertain, and vasogenic edema — a dose-limiting and potentially severe adverse reaction — may limit its clinical applicability.
Keywords: Alzheimer’s disease, β-amyloid peptide (amyloid-β Aβ), Bapineuzumab, Immunotherapy (immunization), Monoclonal antibody, Vasogenic edema