Purpose of Review

Lewy body dementia (LBD) encompasses dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD). This article will emphasize potential disease-modifying therapies as well as investigative symptomatic treatments for non-motor symptoms including cognitive impairment and psychosis that can present a tremendous burden to patients with LBD and their caregivers.

Recent Findings

We review 11 prospective disease-modifying therapies (DMT) including four with phase 2 data (neflamapimod, nilotinib, bosutinib, and E2027); four with some limited data in symptomatic populations including phase 1, open-label, registry, or cohort data (vodabatinib, ambroxol, clenbuterol, and terazosin); and three with phase 1 data in healthy populations (Anle138b, fosgonimeton, and CT1812). We also appraise four symptomatic therapies for cognitive impairment, but due to safety and efficacy concerns, only NYX-458 remains under active investigation. Of symptomatic therapies for psychosis recently investigated, pimavanserin shows promise in LBD, but studies of nelotanserin have been suspended.

Summary

Although the discovery of novel symptomatic and disease-modifying therapeutics remains a significant challenge, recently published and upcoming trials signify promising strides toward that aim.

中文翻译：

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路易体痴呆：有希望的治疗方法概述

审查目的

路易体痴呆(LBD)包括路易体痴呆(DLB)和帕金森病痴呆(PDD)。本文将强调潜在的疾病缓解疗法以及针对非运动症状（包括认知障碍和精神病）的研究性对症治疗，这些症状可能给 LBD 患者及其护理人员带来巨大的负担。

最近的发现

我们回顾了 11 种前瞻性疾病缓解疗法 (DMT)，其中 4 种具有 2 期数据（neflamapimod、nilotinib、bosutinib 和 E2027）；四个在有症状人群中的数据有限，包括 1 期、开放标签、注册或队列数据（沃达巴替尼、氨溴索、克仑特罗和特拉唑嗪）；三个在健康人群中具有 1 期数据（Anle138b、fosgonimeton 和 CT1812）。我们还评估了四种治疗认知障碍的对症疗法，但出于安全性和有效性的考虑，只有 NYX-458 仍在积极研究中。在最近研究的精神病对症疗法中，匹马范色林在 LBD 中显示出前景，但奈洛坦色林的研究已暂停。

概括

尽管新的症状和疾病缓解疗法的发现仍然是一个重大挑战，但最近发表的和即将进行的试验标志着朝着这一目标迈出了有希望的一步。