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Amyloid solutions: lecanemab, gantenerumab, and donanemab in the treatment of Alzheimer's disease
Taha Basit Ameen, Umair Ali, Omme Salma, Muhammad Abdul Samee, Syed Muhammad Iraj Abbas, Syeda Naveera Kashif, Muhammad Arif Arifi, Mashooque Ali et al.. The Egyptian Journal of Neurology Psychiatry and Neurosurgery, 2025-05-08
Topic: Amyloid, tau and blood-test diagnosis
Abstract Alzheimer’s disease (AD), the leading cause of dementia, is a multifaceted neurodegenerative disorder characterized by amyloid-beta (Aβ) aggregation, tau pathology, and neuroinflammation. Recent advances in immunotherapy have yielded monoclonal antibodies (mAbs) with unprecedented precision in targeting Aβ species, offering hope for altering the disease trajectory. Lecanemab’s selective affinity for protofibrillar Aβ disrupts early neurotoxic aggregates, providing a proactive approach for mitigating synaptic dysfunction. Donanemab, by targeting pyroglutamate-modified plaques, combines high specificity with microglial-mediated clearance, while gantenerumab enhances Fc receptor-mediated phagocytosis of both soluble and fibrillar Aβ. These therapies represent a shift from symptomatic treatment to disease modification, reducing the Aβ burden and slowing cognitive decline. However, challenges, such as amyloid-related imaging abnormalities (ARIA), underscore the complexity of balancing efficacy and safety. This review explores the transformative potential of these therapies and contextualizes their mechanisms within the evolving understanding of AD pathophysiology. This highlights the interplay between immune modulation, neuroprotection, and personalized medicine, highlighting the need for future innovations in tackling one of the most formidable challenges in neurology.
Key findings
- Donanemab, by targeting pyroglutamate-modified plaques, combines high specificity with microglial-mediated clearance, while gantenerumab enhances Fc receptor-mediated phagocytosis of both soluble and fibrillar Aβ.
- These therapies represent a shift from symptomatic treatment to disease modification, reducing the Aβ burden and slowing cognitive decline.
- However, challenges, such as amyloid-related imaging abnormalities (ARIA), underscore the complexity of balancing efficacy and safety.
- This review explores the transformative potential of these therapies and contextualizes their mechanisms within the evolving understanding of AD pathophysiology.
- This highlights the interplay between immune modulation, neuroprotection, and personalized medicine, highlighting the need for future innovations in tackling one of the most formidable challenges in neurology.
Why it matters
This review describes three monoclonal antibodies—lecanemab, gantenerumab and donanemab—that target amyloid-beta and are reported to reduce amyloid burden and slow cognitive decline, while carrying risks such as amyloid-related imaging abnormalities. It is a summary of these therapies, not new evidence of a cure or prevention.
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Study details
- Evidence strengthLow
How this study scored 35/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Egyptian Journal of Neurology Psychiatry and Neurosurgery) |
| Journal's citation record | 0 / 4 | The Egyptian Journal of Neurology Psychiatry and Neurosurgery: journal h-index 35 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 13 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 7.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 13 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 0 / 4 | Last-listed author Abdul Raheem: h-index 4 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Liaquat University of Medical & Health Sciences: institution h-index 79 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 2 countries |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 35 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1186/s41983-025-00968-3
- Original source →
- Free full text: The Egyptian Journal of Neurology Psychiatry and Neurosurgery →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Ameen, T. B., Ali, U., Salma, O., Samee, M. A., Abbas, S. M. I., Kashif, S. N., et al. (2025). Amyloid solutions: lecanemab, gantenerumab, and donanemab in the treatment of Alzheimer's disease. The Egyptian Journal of Neurology Psychiatry and Neurosurgery. https://doi.org/10.1186/s41983-025-00968-3
Vancouver
Ameen TB, Ali U, Salma O, Samee MA, Abbas SMI, Kashif SN, et al. Amyloid solutions: lecanemab, gantenerumab, and donanemab in the treatment of Alzheimer's disease. The Egyptian Journal of Neurology Psychiatry and Neurosurgery. 2025. doi:10.1186/s41983-025-00968-3.
BibTeX
@article{ameen2025-2abd646d,
author = {Ameen, Taha Basit and Ali, Umair and Salma, Omme and Samee, Muhammad Abdul and Abbas, Syed Muhammad Iraj and Kashif, Syeda Naveera and Arifi, Muhammad Arif and Ali, Mashooque and others},
title = {{Amyloid solutions: lecanemab, gantenerumab, and donanemab in the treatment of Alzheimer's disease}},
journal = {The Egyptian Journal of Neurology Psychiatry and Neurosurgery},
year = {2025},
doi = {10.1186/s41983-025-00968-3},
url = {https://doi.org/10.1186/s41983-025-00968-3}
}
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