Bayes analysis supports null hypothesis of anti-amyloid beta therapy in Alzheimer's disease.
Alzheimers Dement
; 17(6): 1051-1055, 2021 06.
Article
en En
| MEDLINE
| ID: mdl-34057297
ABSTRACT
Numerous clinical trials of anti-amyloid beta (Aß) immunotherapy in Alzheimer's disease have been performed. None of these have provided convincing evidence for beneficial effects. Using traditional frequentist meta-analysis, the conclusion is that there is absence of evidence for a therapeutic effect, with a point estimate effect size of 0.05 (95% confidence interval -0.00 to 0.10, P = .055). In addition, this non-significant effect equates to 0.4 points per year on the cognitive subscale of the Alzheimer's Disease Assessment Scale. This is well below the minimally clinically important difference. Bayesian meta-analysis of these trial data provides strong evidence of absence of a therapeutic effect, with a Bayes factor of 11.27 in favor of the null hypothesis, opposed to a Bayes factor of 0.09 in favor of a treatment effect. Bayesian analysis is particularly valuable in this context of repeatedly reported small, non-significant effect sizes in individual trials. Mechanisms other than removal of Aß from the brain may be probed to slow progression of Alzheimer's disease.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Ensayos Clínicos Controlados Aleatorios como Asunto
/
Teorema de Bayes
/
Enfermedad de Alzheimer
/
Inmunoterapia
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Alzheimers Dement
Año:
2021
Tipo del documento:
Article
País de afiliación:
Países Bajos