In summary
* A Cochrane report was published in April 2026, which evaluated a class of drugs used for Alzheimer’s disease (AD) (amyloid-beta-targeting monoclonal antibodies).
* The conflict-free Cochrane report was a systematic review and meta-analysis of randomised controlled trials, so it is the best evidence we have on this topic.
* It concluded that drugs that target amyloid-beta proteins in the brain likely have no clinically meaningful positive effects for AD, while increasing the risk of bleeding and swelling in the brain.
* It went further, by suggesting that future research needs to move away from the amyloid-beta protein hypothesis and focus on other pathways.
* While reviewing the Cochrane report I checked which of the nine drugs had been approved in the US or UK. The results were surprising.
* The industry and AD charity response to the Cochrane report was – Cochrane have pooled trials where drugs have been approved with trials where drugs haven’t been approved. Cochrane should only have included trials for approved drugs i.e., the ones that showed more benefit than harm.
* This note revisits a review I did in September 2023 of one approved drug – lecanemab – and what my ‘bottom line’ was then.
* Since September 2023, I have read a book by science journalist Charles Piller called “Doctored: Fraud, Arrogance and Tragedy in the Quest to Cure Alzheimer’s.” That book and this recent Cochrane review make a compelling case that the amyloid protein hypothesis is wrong.
* If the amyloid protein hypothesis is wrong, decades of research and $600 BILLION has been wasted pursuing the wrong approach. If “Doctored” is right, scientific fraud and corruption doesn’t get much bigger than this.
Introduction
On 16th April 2026 I was doing my usual brief check on what’s happening in the world with my enormous latte when a story caught my eye. It was reported in mainstream media both sides of the pond “Effect of ‘gamechanger’ Alzheimer’s drugs ‘trivial’, review concludes” (UK) (Ref 1) and “Analysis of Alzheimer’s Drugs Stirs Debate About Their Effectiveness” (US) (Ref 2). It was reported in academic literature (the BMJ) “Alzheimer’s drugs targeting amyloid do not produce clinically meaningful effects, concludes Cochrane review” (Ref 3). It was reported in Scientific American “Effect of antiamyloid Alzheimer’s drugs ‘absent or trivial,’ Cochrane review finds” (Ref 4).
The story came from a just-published Cochrane review with the title “Amyloid-beta-targeting monoclonal antibodies for people with mild cognitive impairment or mild dementia due to Alzheimer’s disease (Review)” (Ref 5). A press release for the review was published here (Ref 6). The press release was as strident as any I have read. Here are some extracts:
Zoe
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