LAUSR

Anti-amyloid immunotherapies will provide the first disease-modifying therapeutics Few of life's experiences evoke greater apprehension than a diagnosis of Alzheimer's disease (AD). Virtually unknown to the public until the 1980s, it is alone among the 10 most common fatal diseases of developed nations in lacking a disease-modifying treatment. AD affects people of all ethnicities; in the United States, African Americans have twice the prevalence of European Americans (1). The cumulative financial cost to society of late-life dementias (of which AD comprises ∼60%) is estimated to exceed those of heart disease and cancer (2). This dismal reality may now be changing. The properties of the key proteins comprising the amyloid plaques [amyloid-β (Aβ)] and neurofibrillary tangles (tau) that define the neuropathology of AD have been identified. Coupled with extensive genetic studies, a sequence of lesion formation in brain networks serving memory and cognition is suggested. Antibodies that target these proteins are in advanced trials, and aducamumab, which clears Aβ, was recently approved, though not without controversy.