Anti-amyloid drugs face a damning verdict — but the newest ones may be different |
A major new analysis of 17 clinical trials with more than 20,000 participants concluded that the current front line in Alzheimer’s treatment — anti-amyloid drugs — are unlikely to make a significant difference to either the severity of symptoms or extent of cognitive decline. They also appear to raise the risk of brain swelling and bleeding.
The lead author, neurologist Francesco Nonino, MD, was direct in his assessment: “There is now a convincing body of evidence converging on the conclusion that there is no clinically meaningful effect.”
But several prominent neurologists pushed back on what the data actually shows.
The review pooled the results from older, largely failed drug trials alongside the recently approved lecanemab and donanemab. Those newer drugs did show statistically significant slowing of decline in their own trials. Whether that translates to meaningful benefit versus real risks is the question researchers are still investigating.
Paul Monroe Butler, MD, PhD, of Harvard Medical School and a neurologist at Mass General Brigham, said: “I wouldn’t accept the premise that anti-amyloid therapy has no clinical viability.”
Researchers are also pursuing tau-targeting therapies, dampening inflammation pathways, and combined approaches that treat Alzheimer’s as the complex disease it appears to be.
For more on what the review says, and what the next generation of treatment might look like, jump to “Alzheimer’s disease: Do anti-amyloid drugs actually work?”
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