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Alzheimer's & dementia : the journal of the Alzheimer's Association
Published

Use of anti-amyloid-β monoclonal antibodies in persons with Down syndrome Alzheimer's disease

Authors

Clíona Farrell, Fedal Saini, Mona M Beidas, Natalie S Ryan, Andre Strydom, Frances K Wiseman

Abstract

Alzheimers Dement. 2026 Apr;22(4):e71404. doi: 10.1002/alz.71404.

ABSTRACT

INTRODUCTION: The recent development and licensing of anti-amyloid-β monoclonal antibodies for the treatment of early-stage Alzheimer's disease have significantly shifted the clinical landscape. However, current use recommendations preclude the administration of these new drugs to persons who have Down syndrome.

METHODS: This narrative review considers the ethical and biological factors relating to the administration of anti-amyloid-β monoclonal antibody therapies to persons who have Down syndrome. Literature was selected based on relevance.

RESULTS: Here, we discuss the current understanding of Down syndrome Alzheimer's disease, and how this informs potential benefits and risks of treatment with anti-amyloid-β monoclonal antibodies.

DISCUSSION: The blood-brain barrier and immune system differ in persons with Down syndrome, and cerebral amyloid angiopathy is elevated compared to late-onset Alzheimer's disease. Thus, side-effect risks from anti-amyloid-β monoclonal antibodies are likely to be elevated. Further research is needed to facilitate the treatment of persons with Down syndrome with these new therapies.

PMID:42043831 | DOI:10.1002/alz.71404

UK DRI Authors