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Alzheimer’s disease (AD) is a neurodegenerative condition marked by cognitive decline and eventually death. The main pathological features of AD include amyloid-β (Aβ) plaques and neurofibrillary tangles, but oxidative stress and inflammation are also major contributors to AD progression. Current pharmacologic treatments only address symptoms, and many trials targeting amyloid and non-amyloid pathways have failed.

Given that about 90% of circulating Aβ is bound to albumin, plasma exchange (PE) with albumin replacement has emerged as a promising therapeutic approach, known as the AMBAR (Alzheimer Management by Albumin Replacement) Program. This approach involves removing the patient’s plasma to eliminate toxic substances, including Aβ and impaired albumin, and replacing it with therapeutic albumin. Albumin replacement serves multiple functions: it expands plasma volume, binds Aβ, transports substances, and acts as a detoxifier and antioxidant, which may be beneficial for AD treatment.

Positive results from AMBAR trials (phases 1, 2, and 2b/3) showed slowed decline or stabilization of symptoms, providing hope for AD patients and their caregivers as a potential multitargeted AD therapy.