Evolving Strategies in Alzheimer's Diagnosis and Management: Antibodies and Biomarkers

The pathways elucidated by new biomarkers in Alzheimer's disease are redefining therapeutic timing and linking diagnostic precision to treatment efficacy. Biomarkers such as blood, CSF, and PET scans are transforming Alzheimer’s diagnosis by enabling earlier and more accurate detection.

Additionally, pivotal trials of monoclonal antibodies suggest modest clinical benefit in selected patients. Lecanemab and donanemab have shown promise in slowing cognitive decline. These treatments target beta-amyloid, one of the pathological hallmarks of Alzheimer's, and are backed by substantial clinical evidence.

Effect sizes are modest, eligibility criteria can be restrictive, and amyloid‑lowering antibodies carry risks such as ARIA that require MRI monitoring and careful patient selection.

Not every patient responds uniformly to new medications, underscoring the importance of stratifying care. Biomarker profiles help identify candidates most likely to benefit and those at higher risk of adverse effects, guiding eligibility criteria, dosing, and timing alongside shared decision-making.