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Home > Recalibrating the Risk-Benefit Profiles of Lecanemab and Donanemab: Scales, Immunoreactivity, and Changes in Amyloid-β42.

TitleRecalibrating the Risk-Benefit Profiles of Lecanemab and Donanemab: Scales, Immunoreactivity, and Changes in Amyloid-β42.
Publication TypeJournal Article
Year of Publication2024
AuthorsEspay, AJ, Herrup, K, Imbimbo, BP, Kepp, KP, Daly, T
JournalJ Alzheimers Dis
Volume99
Issue3
Pagination877-881
Date Published2024
ISSN1875-8908
KeywordsAlzheimer Disease, Amyloid beta-Peptides, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Humans, Peptide Fragments, Risk Assessment
Abstract

Three recent anti-amyloid-β antibody trials for Alzheimer's disease reported similar effect sizes, used non-reactive saline as placebo, and showed large numbers of adverse events including imaging anomalies (ARIA) that correlate with cognitive changes. Conversely, all previous antibody trials were less reactive and pronounced ineffective. We argue that these observations point to unblinding bias, inflating apparent efficacy and thus altering the risk-benefit balance. Further, we highlight data demonstrating that beyond reducing amyloid, monoclonal antibodies increase monomeric amyloid-β42 in cerebrospinal fluid, which may explain potential benefits. We should recalibrate the efficacy of these antibodies and devote more resources into strategies beyond removing amyloid.

DOI10.3233/JAD-240171
Alternate JournalJ Alzheimers Dis
PubMed ID38701151
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Source URL: https://www.j-alz.com/content/recalibrating-risk-benefit-profiles-lecanemab-and-donanemab-scales-immunoreactivity-and