A systematic review and meta-analysis of clinical trials of anti-amyloid beta (Aβ) drugs used in patients with Alzheimer’s disease have revealed that these drugs can cause accelerated brain volume loss, according to new research published in the journal Neurology.
The study, which analysed data from 31 clinical trials involving 8,062 to 10,279 adults, aimed to evaluate the effects of different sub-classes of anti-Aβ drugs on brain volume changes. The researchers found that the drugs’ impact on brain volume varied by drug class. Secretase inhibitors, which block the production of Aβ, were found to accelerate atrophy to the hippocampus and whole brain, while monoclonal antibodies that induce amyloid-related imaging abnormalities (ARIA) accelerated ventricular enlargement.
The researchers also observed a striking correlation between ventricular volume and ARIA frequency. Moreover, they projected that individuals with mild cognitive impairment who were treated with anti-Aβ drugs could regress toward brain volumes typical of Alzheimer’s dementia approximately eight months earlier than those who were untreated.
The authors suggest six recommendations based on these findings, including the need for more extensive monitoring of drug-induced ARIA, the need for more precise monitoring of brain volume changes during clinical trials, and the need for further research to better understand the mechanisms underlying the observed effects.
This research highlights the importance of carefully monitoring the effects of anti-Aβ drugs, which are currently being trialled as a treatment for Alzheimer’s disease. While these drugs may have some beneficial effects, they can also cause harm, and it is essential that we fully understand their impact on brain health.
The findings are particularly significant given the widespread use of anti-Aβ drugs in clinical trials and the growing interest in developing treatments for Alzheimer’s disease. The authors note that the use of anti-Aβ drugs as a treatment for Alzheimer’s disease is a major area of research and has received considerable funding in recent years. It is essential that we continue to evaluate the risks and benefits of these drugs, and that we carefully consider the long-term implications of their use.
Overall, the study’s findings highlight the need for greater caution in the development of anti-Aβ drugs and underscore the importance of more extensive monitoring of their impact on brain health.