Table 4 Benefits and challenges of the active immunotherapies for alzheimer’s disease

Advantages

 Natural immune response

 Persistent amyloid-beta protein antibody titer levels

 Infrequent re-administrations

 Suitable for long-term therapy

 Good compliance

 Reduced cost

 Low antigen dose

 Potential polyclonal response

 Peak titers are reached gradually

 Avidity maturation of antibodies

 Reduced risk of anaphylaxis reactions

Disadvantages

Challenges

 Relies on patients’ own immune response

 Autoreactive T-cell responses need to be avoided

 An understanding of the relationship of responses to clinical outcomes is required

 Generation of antibody responses in older patients

 Development of tolerance to be avoided

 Risk of developing an autoimmune response

 Risk of developing amyloid-related imaging abnormalities