{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T05:23:20Z","timestamp":1794374600395,"version":"4.9.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anti-amyloid monoclonal antibodies offer a treatment strategy for early Alzheimer's disease, but their modest efficacy must be weighed against important safety concerns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the efficacy and safety of aducanumab, lecanemab, and donanemab in randomized placebo-controlled trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      PubMed, Cochrane, and ClinicalTrials.gov were searched through February 2026 for randomized placebo-controlled trials evaluating aducanumab, lecanemab, or donanemab in early symptomatic Alzheimer's disease. Outcomes included Clinical Dementia Rating\u2013Sum of Boxes (CDR-SB), Alzheimer's Disease Assessment Scale\u2013Cognitive Subscale (ADAS-Cog), Mini-Mental State Examination (MMSE), amyloid-related imaging abnormalities\u2013edema\/effusion (ARIA-E), amyloid-related imaging abnormalities\u2013hemosiderin deposition (ARIA-H), and\n                      <jats:italic toggle=\"yes\">APOE<\/jats:italic>\n                      \u03b54-stratified ARIA-E. Random-effects meta-analyses were performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven trials were included. Treatment favored intervention for ADAS-Cog (SMD \u22120.15, 95% CI \u22120.21 to \u22120.10), CDR-SB (MD \u22120.41, 95% CI \u22120.63 to \u22120.18), and MMSE (MD 0.44, 95% CI 0.03 to 0.86), although effects were small. Treatment increased ARIA-E (23.9% versus 1.9%; RR 11.65, 95% CI 9.06 to 14.99) and ARIA-H (16.8% versus 6.8%; RR 2.45, 95% CI 1.94 to 3.09). Among treated participants with\n                      <jats:italic toggle=\"yes\">APOE<\/jats:italic>\n                      \u03b54-stratified ARIA-E data,\n                      <jats:italic toggle=\"yes\">APOE<\/jats:italic>\n                      \u03b54 carriers had higher ARIA-E risk than non-carriers (29.3% versus 13.8%; RR 2.10, 95% CI 1.67 to 2.64). Brain-volume loss, ventricular enlargement, and treatment-related deaths were narratively identified but not pooled.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Aducanumab, lecanemab, and donanemab showed statistically significant but small slowing of decline that may not reach patient-perceptible clinical meaningfulness. Increased ARIA risk and additional safety signals support cautious selection, imaging surveillance, and individualized risk-benefit discussions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261488812","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:07:04Z","timestamp":1790604424000},"page":"555-568","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of aducanumab, lecanemab, and donanemab in Alzheimer's disease: A meta-analysis of randomized controlled trials"],"prefix":"10.1177","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1138-4892","authenticated-orcid":false,"given":"Muaz","family":"Ali","sequence":"first","affiliation":[{"name":"Department of Neurology, Cleveland Clinic Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haroon","family":"Shabbir","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rawalpindi Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maheen","family":"Shaharyar","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rawalpindi Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6765-9120","authenticated-orcid":false,"given":"Sindu","family":"Mukesh","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cleveland Clinic Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cleveland Clinic Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mansour","family":"Afshani","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cleveland Clinic Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Kalra","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cleveland Clinic Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Koriesh","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cleveland Clinic Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7218a3"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.646050"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0165-6147(91)90609-V"},{"key":"e_1_3_3_5_2","volume-title":"BLA accelerated approval: Aduhelm (aducanumab-avwa), BLA 761178","author":"US Food and Drug Administration","unstructured":"US Food and Drug Administration. 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