Do anti-amyloid therapies demonstrate clinically meaningful benefit? A Bayesian reappraisal
Tommaso Costa1,2,3, Stefano L Sensi4,5,6,7, Poul F Høilund-Carlsen8,9
1Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
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.
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