Alzheimer’s drugs targeting amyloid don’t help, review finds

A major review concludes that drugs designed to clear amyloid plaques from the brain fail to improve memory or thinking in Alzheimer's patients, challenging a core hypothesis of the field. | Contesto: cronaca

Punti chiave

• Alzheimer’s drugs targeting amyloid don’t help, review finds

Contesto

A comprehensive review of clinical trial data has concluded that a class of drugs designed to treat Alzheimer's disease by clearing amyloid plaques from the brain does not improve cognitive function or slow its decline in patients. The findings, drawn from an analysis of multiple high-profile drug trials, directly challenge the decades-old "amyloid hypothesis," which has been the dominant theory driving Alzheimer's research and drug development since the 1990s. The amyloid hypothesis posits that the accumulation of sticky amyloid-beta protein fragments in the brain is the primary cause of Alzheimer's, triggering a cascade of events that leads to neuron death, brain shrinkage, and dementia. For over thirty years, billions of dollars in research funding have been funneled into developing therapies—primarily monoclonal antibodies—that target and remove these plaques. Several of these drugs, including aducanumab (Aduhelm) and lecanemab (Leqembi), have recently received controversial accelerated approvals from the U.S. Food and Drug Administration based on their demonstrated ability to reduce amyloid levels. However, this new analysis reveals a critical disconnect. While the drugs are biologically active and successfully achieve their stated goal of amyloid plaque removal, this biochemical success does not translate into meaningful clinical benefit for patients. The review found no consistent, statistically significant improvement in measures of memory, reasoning, or daily living activities compared to placebo. The results suggest that simply clearing the protein may be too little, too late, or that amyloid is not the central driver of the disease's debilitating symptoms as long believed. The implications for patients, families, and the healthcare system are profound. Drugs like lecanemab carry significant risks, including brain swelling and bleeding, and carry annual price tags exceeding $26,000. The review raises urgent ethical and economic questions about the value of widespread treatment with agents that carry substantial risk and cost for no clear cognitive benefit. It also casts a shadow over the regulatory pathways that led to their approval, which relied on...

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Categoria: cronaca