A major Cochrane review of 17 clinical trials involving over 20,000 people shows that the new anti-amyloid Alzheimer’s drugs do not deliver meaningful clinical benefit.
“The absolute effects of anti-amyloid drugs on cognitive decline and dementia severity were absent or trivial, falling well below established thresholds for the minimum clinically important difference,” conclude the researchers.
The lead author, Francesco Nonino, neurologist and epidemiologist at the IRCCS Institute of Neurological Sciences of Bologna, Italy, adds: “Unfortunately, the evidence suggests that these drugs make no meaningful difference to patients. There is now a convincing body of evidence converging on the conclusion that there is no clinically meaningful effect. While early trials showed results that were statistically significant, it is important to distinguish between this and clinical relevance.”
These trials, and the research behind them, have involved substantial global investment over many years from pharmaceutical companies, governments and charities, reflecting the scale and urgency of the challenge Alzheimer’s presents.
This may be shocking, but the evidence is increasingly pointing in a different direction than the one many have assumed. Researchers are recognising that amyloid may be a downstream effect of the disease process rather than its primary cause. As a result, approaches that focus solely on reducing amyloid may be too narrow to deliver meaningful clinical benefit, as this review makes clear.
“Anti-amyloid trials also raise important scientific and ethical questions”, says Emeritus Professor of Pharmacology and member of the Scientific Advisory Board of foodforthebrain.org, David Smith, from the University of Oxford. “Is it justifiable to ask patients to undergo yet more trials of anti-amyloid treatments?” he asks.
That’s the bad news.
Prevention does work
The good news is that prevention does work. Evidence shows that correcting low levels of B vitamins and omega-3 can produce significant clinical benefit in those with early cognitive decline, without the risks associated with drug interventions.
Practical tools are already available to support this approach. The free, validated Cognitive Function Test, used by over 450,000 people globally, allows individuals to assess their brain health and understand their personal risk factors, offering a starting point for prevention.
More good news is that next week, on April 28th, world-leading experts will come together at the Alzheimer’s Prevention: New Frontiers conference, hosted by foodforthebrain.org.
This online event brings together leading international experts to present the latest evidence on what drives cognitive decline and, importantly, what can be done about it. Topics include nutrition, brain energy, omega-3 and B vitamin status, blood sugar balance, sleep, stress, gut health, physical activity and hormonal changes, all brought together into a practical, evidence-based prevention framework.
Neurologist Dr David Perlmutter and speaker at the conference, says: “Becoming an Alzheimer’s patient is almost always a choice. This conference will explain why.”
