{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:21:36Z","timestamp":1791411696176,"version":"4.3.3"},"reference-count":55,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T00:00:00Z","timestamp":1722902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Recent approvals of amyloid immunotherapy drugs for early Alzheimer's disease (AD) have been highly controversial. In this piece, we consider challenges from the clinical, population health, and health systems perspectives to the role that the new AD drugs might be expected to play, now and in the future, in alleviating the morbidity caused by AD in the population. Clinically, short\u2010term effects are small, adverse events are frequent, treatment regimens are burdensome, and, crucially, long\u2010term effects are unknown. At a population level, there is always likely to be a trade\u2010off between breadth of access and magnitude of benefit for any given individual. At a health system level, roll out of treatment even for only narrowly\u2010defined patient groups will involve considerable resources to identify and treat eligible patients, with profound opportunity costs. Our considered view on current evidence is that there are challenges from each perspective to imagining a foreseeable future in which amyloid immunotherapy significantly alleviates AD morbidity at scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Recent approvals of Alzheimer's drugs have met with excitement but also controversy.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Trial effects are small, adverse effects concerning, and long\u2010term effects unknown.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Results from trial cohorts may not generalize to broader, more complex patients.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Significant resource requirements of eligibility assessment and drug administration.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Use in \u201cpresymptomatic\u201d populations is not supported by current evidence.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.14108","type":"journal-article","created":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T07:00:45Z","timestamp":1722927645000},"page":"6639-6646","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Considering challenges for the new Alzheimer's drugs: Clinical, population, and health system perspectives"],"prefix":"10.1002","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8894-5006","authenticated-orcid":false,"given":"Sebastian","family":"Walsh","sequence":"first","affiliation":[{"name":"Cambridge Public Health University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Merrick","sequence":"additional","affiliation":[{"name":"Cambridge Public Health University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Milne","sequence":"additional","affiliation":[{"name":"Cambridge Public Health University of Cambridge  Cambridge UK"},{"name":"Kavli Centre for Ethics, Science, and the Public University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley","family":"Nurock","sequence":"additional","affiliation":[{"name":"Cambridge Public Health University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edo","family":"Richard","sequence":"additional","affiliation":[{"name":"Department of Neurology Donders Institute for Brain Cognition and Behaviour Radboud University Medical Centre  Nijmegen The Netherlands"},{"name":"Department of Public and Occupational Health Amsterdam UMC University of Amsterdam  Amsterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Brayne","sequence":"additional","affiliation":[{"name":"Cambridge Public Health University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,6]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"World Health Organization.Dementia.2023. 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