Do anti-amyloid therapies demonstrate clinically meaningful benefit? A Bayesian reappraisal

BackgroundRecent anti-amyloid trials have been interpreted as evidence of clinical benefit in Alzheimer's disease, although their relevance remains debated.ObjectiveTo reinterpret pooled randomized evidence on anti-amyloid therapies within a Bayesian framework focused on benefit and harm.MethodsPooled estimates from a recent Cochrane review were reanalyzed using posterior probability estimation with clinically relevant thresholds.ResultsThe probability that treatment effects reached clinically meaningful thresholds was generally low, whereas the probability of substantial harm, particularly amyloid-related imaging abnormalities, was high.ConclusionsCurrent randomized evidence suggests that statistically significant anti-amyloid effects may not translate into clinically meaningful benefit.

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Publication Details

Journal
Journal of Alzheimer s Disease
Published
2026-07-23
DOI
https://doi.org/10.1177/13872877261469870
Primary Topic
Dementia and Cognitive Impairment Research
Type
article
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article

Do anti-amyloid therapies demonstrate clinically meaningful benefit? A Bayesian reappraisal

Tommaso Costa, Poul Flemming Høilund‐Carlsen, Alberto J. Espay, Bryce Vissel et al.
Journal of Alzheimer s Disease
Dementia and Cognitive Impairment Research
article

Do anti-amyloid therapies demonstrate clinically meaningful benefit? A Bayesian reappraisal

Tommaso Costa, Poul Flemming Høilund‐Carlsen, Alberto J. Espay, Bryce Vissel, N.K. Robakis, Stefano L. Sensi
article en

Abstract

BackgroundRecent anti-amyloid trials have been interpreted as evidence of clinical benefit in Alzheimer's disease, although their relevance remains debated.ObjectiveTo reinterpret pooled randomized evidence on anti-amyloid therapies within a Bayesian framework focused on benefit and harm.MethodsPooled estimates from a recent Cochrane review were reanalyzed using posterior probability estimation with clinically relevant thresholds.ResultsThe probability that treatment effects reached clinically meaningful thresholds was generally low, whereas the probability of substantial harm, particularly amyloid-related imaging abnormalities, was high.ConclusionsCurrent randomized evidence suggests that statistically significant anti-amyloid effects may not translate into clinically meaningful benefit.

Journal of Alzheimer s Disease
University of Southern Denmark (DK), Odense University Hospital (DK), University of Chieti-Pescara (IT), Saint Vincent's Catholic Medical Center (US), The Catholic University of Korea St. Vincent's Hospital (KR), St. Vincent Hospital (US), Neuroscience Institute (IT), Ospedale Koelliker (IT), St Vincent's Clinic (AU), Ospedale SS. Annunziata (IT), University of Turin (IT), University of Cincinnati (US)
Openalex Percentile: Top 8%
Dementia and Cognitive Impairment Research
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