Are Monoclonal Antibody Therapies Worth the Risk in Mild Dementia?

Amyloid-beta–targeting monoclonal antibody therapies (Ab-mAbs) reduce the build-up of amyloid proteins in the brain. Some Ab-mAbs (donanemab and lecanemab) are FDA-approved for the treatment of mild cognitive impairment (MCI) and mild dementia due to Alzheimer’s disease (AD); however, other international agencies’ decisions regarding these treatments and others in this class have been discordant. To assess clinical benefits and harms of Ab-mAbs, researchers conducted a Cochrane review of randomized controlled trials that compared a total of seven Ab-mAbs to placebo or no treatment in patients with MCI or mild AD-related dementia. They included 17 studies with more than 20,000 participants total; mean age ranged from 70 to 74 years.