Date of Award
2027
Document Type
Capstone
Degree Name
Master of Science (MS)
Department
Physician Assistant Studies
Committee Chair
LaDonna Clark
Abstract
Alzheimer’s disease is a detrimental neurodegenerative disorder that is the leading cause of dementia worldwide. Without a cure, this disease slowly robs patients of their dignity and livelihoods. Traditionally, pharmacologic management has relied on symptomatic relief with acetylcholinesterase inhibitors (AChEIs). However, new monoclonal antibodies (mAbs) targeting amyloid-beta plaques may be the first disease modifying therapy. The purpose of this clinical review was to compare the efficacy, safety, and clinical utility of mAbs and AChEIs in the management of Alzheimer’s disease.
A comprehensive PubMed search was conducted through June 2026 using terms related to monoclonal antibodies, acetylcholinesterase inhibitors, and Alzheimer’s disease. Filters were applied for randomized controlled trials, systematic reviews, and meta-analyses published within the past five years in English with free full-text availability. Four articles were selected for review based on their relevance.
Across the reviewed studies, mAbs demonstrated statistically significant but minimal slowing of cognitive decline in comparison to the placebo and AChEIs. Lecanemab and donanemab produced the most favorable outcomes. While these therapies showed disease-modifying activity, clinical improvements often remained below established thresholds for meaningful change. In comparison, AChEIs provided symptomatic benefits but did not demonstrate declining disease progression. Notably, mAb treatment was associated with risks of amyloid-related imaging abnormalities.
Evidence suggests that mAbs offer a modest advantage over AChEIs in slowing progression and improving disease biomarkers. However, clinical benefits remain limited by safety considerations. mAbs represent a promising advancement in Alzheimer’s disease management, though further research is required to impact future standards of care.
Recommended Citation
Hardy MB. Comparing Monoclonal Antibodies Targeted at Amyloid-beta Plaques’ Efficacy to Acetylcholinesterase Inhibitors in Alzheimer’s Disease Management. The PA Department Journal of Medical Science. 2026. https://digitalcommons.gardner-webb.edu/pa-department-journal-of-medical-science/92
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