Monoclonal Antibodies Provide Small Benefits in Alzheimer Disease

FRIDAY, Jan. 26, 2024 (HealthDay News) -- Monoclonal antibodies targeting amyloid provide small benefits on cognitive and functional scales, which do not meet the minimal clinically important difference, according to a review published in the January/February issue of the Annals of Family Medicine.

Mark H. Ebell, M.D., from the University of Georgia in Athens, and colleagues conducted a meta-analysis to evaluate clinically meaningful benefits and harms of monoclonal antibodies targeting amyloid in patients with Alzheimer dementia. Nineteen publications with 23,202 total participants that examined eight anti-amyloid antibodies were identified.

The researchers identified small improvements over placebo in the Alzheimer's Disease Assessment Scale-Cog-11 to -14 score, Mini Mental State Examination score, and Clinical Dementia Rating-Sum of Boxes scale score, as well as the combined functional scores. None of the changes exceeded the minimal clinically important difference, including lecanemab, aducanumab, and donanemab. Significantly increased risks for amyloid-related imaging abnormalities (ARIA)-edema (relative risk [RR], 10.29), ARIA-hemorrhage (RR, 1.74), and symptomatic ARIA-edema (RR, 24.3) were identified as harms (number needed to harm: nine, 13, and 86, respectively).

"Our meta-analysis shows that monoclonal antibodies targeting amyloid do not provide a clinically meaningful benefit, are associated with significant harms, and come at a high cost," the authors write.

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