BCHE and Alzheimer disease: Monoclonal antibodies such as aducanumab, lecanemab, and donanemab have emerged as the first disease-modifying therapies for AD by targeting and clearing amyloid-β plaques, but their modest cognitive benefits, serious side effects, and high costs [23,24] have limited their widespread use, leaving cholinesterase inhibitors and NMDA antagonists as the mainstay of AD treatment.