Condition

Alzheimer's Disease

Clinical trials and treatment information for Alzheimer's Disease, the most common form of dementia.

37M
People Affected
300
Active Trials
1.1M
New Cases/Year
1.3M
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Donanemab
57% Effectivenessβ€’ 78% Confidenceβ€’ 48% Safetyβ€’ 10 trialsβ€’ 3.5K participants
MODERATE EvidencePoor ValueDose: 700 mg IV every 4 weeks for first 3 doses, then 1400 mg IV every 4 weeks
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
MethπŸ’€
Cigarettes🚬
Chemo☒️
Alcohol🍺
MorphineπŸ’Š
AntibioticsπŸ’‰
TylenolπŸ’Š
ExerciseπŸƒ
WaterπŸ’§
48
DangerousModerateSafe

Time to Effect

6-12 months

Duration

Until amyloid clearance (6-18 months), then monitoring

Response Rate

%

Remission Rate

%

Number Needed to Treat (NNT)

9

Number Needed to Harm (NNH)

4

Common Side Effects:

ARIA-E (edema): 24%
ARIA-H (hemorrhage): 31%
Headache: 10%
Infusion-related reactions: 8.7%

Annual Cost of Care

Drug Cost

$27,500

Monitoring

$8,000

Side Effects

$2,500

Total Annual

$38,000

Cost-Effectiveness

POOR

QALYs Gained

0.22

ICER

$600,000/QALY

Treatment Outcomes
Primary Outcomes
Clinical Dementia Rating-Sum of Boxes (CDR-SB)3.0 points (on a 0-18 scale)
+36.8% (-0.7 points (less decline compared to placebo over 18 months))
Amyloid Plaque Burden (PET Centiloids)100 Centiloids
-80% (-80 Centiloids (reduction to amyloid-negative status))
Integrated Alzheimer's Disease Rating Scale (iADRS)80 points (on a 0-144 scale)
+29% (+2.9 points (less decline compared to placebo over 18 months))
Secondary Benefits
Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog13)25 points (on a 0-85 scale)
+26% (-1.3 points (less worsening compared to placebo over 18 months))
ADCS-Activities of Daily Living - Mild Cognitive Impairment (ADCS-ADL-MCI)75 points (on a 0-78 scale)
+40% (+1.2 points (less decline compared to placebo over 18 months))
Tau Pathology (PET SUVR - medial temporal lobe)1.4 SUVR (medial temporal lobe)
-6.7% (-0.09 SUVR)
Common Side Effects
ARIA-E (edema)
+24%
ARIA-H (hemorrhage)
+31%
Headache
+10%

Clinical Trial Phases:

Phase 3
2
Lecanemab
55% Effectivenessβ€’ 80% Confidenceβ€’ 50% Safetyβ€’ 26 trialsβ€’ 3K participants
MODERATE EvidencePoor ValueDose: 10 mg/kg intravenous infusion biweekly
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
MethπŸ’€
Cigarettes🚬
Chemo☒️
Alcohol🍺
MorphineπŸ’Š
AntibioticsπŸ’‰
TylenolπŸ’Š
ExerciseπŸƒ
WaterπŸ’§
50
DangerousModerateSafe

Time to Effect

6-12 months

Duration

Ongoing

Response Rate

%

Remission Rate

%

Number Needed to Treat (NNT)

16

Number Needed to Harm (NNH)

8

Common Side Effects:

Infusion-related reactions: 26%
ARIA-E (edema): 13%
ARIA-H (hemorrhage): 17%
Headache: 13%

Annual Cost of Care

Drug Cost

$26,500

Monitoring

$8,000

Side Effects

$2,000

Total Annual

$36,500

Cost-Effectiveness

POOR

QALYs Gained

0.23

ICER

$640,000/QALY

Treatment Outcomes
Primary Outcomes
Clinical Dementia Rating-Sum of Boxes (CDR-SB)3.2 points (CDR-SB 0-18 scale)
+27% (-0.45 points (less increase compared to placebo's change from baseline))
Alzheimer's Disease Assessment Scale-Cognitive Subscale 14 (ADAS-Cog14)27.0 points (ADAS-Cog 0-90 scale)
+26% (-1.44 points (less increase compared to placebo's change from baseline))
Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-MCI-ADL)78.0 points (ADCS-MCI-ADL 0-87 scale)
+37% (+2.0 points (less decrease compared to placebo's change from baseline))
Brain Amyloid Plaque (PET Centiloids)79.0 Centiloids
-70.3% (-55.5 Centiloids)
Secondary Benefits
CSF p-tau18123.0 pg/mL
-20.6% (-4.7 pg/mL)
CSF AΞ²42/40 ratio0.09
+6.6% (+0.006)
Plasma p-tau18120.0 pg/mL
-14% (-2.8 pg/mL)
Common Side Effects
Infusion-related reactions
+26%
ARIA-E (edema)
+13%
ARIA-H (hemorrhage)
+17%

Clinical Trial Phases:

Phase 3Phase 4
3
Donepezil
45% Effectivenessβ€’ 90% Confidenceβ€’ 60% Safetyβ€’ 202 trialsβ€’ 30K participants
HIGH EvidenceExcellent ValueDose: 5-10 mg orally once daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
MethπŸ’€
Cigarettes🚬
Chemo☒️
Alcohol🍺
MorphineπŸ’Š
AntibioticsπŸ’‰
TylenolπŸ’Š
ExerciseπŸƒ
WaterπŸ’§
60
DangerousModerateSafe

Time to Effect

4-6 weeks

Duration

Lifetime

Response Rate

25%

Remission Rate

%

Number Needed to Treat (NNT)

9

Number Needed to Harm (NNH)

12

Common Side Effects:

Nausea: 11%
Diarrhea: 9%
Insomnia: 9%
Muscle cramps: 8%
Vomiting: 6%

Annual Cost of Care

Drug Cost

$75

Monitoring

$400

Side Effects

$50

Total Annual

$525

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.05

Cost per Responder

$2,100

Treatment Outcomes
Primary Outcomes
ADAS-Cog Score27 points (Scale: 0-75, higher is worse)
-9.3% (-2.5 points)
MMSE Score19 points (Scale: 0-30, higher is better)
+7.9% (+1.5 points)
CDR-SB Score7 points (Scale: 0-18, higher is worse)
-11.4% (-0.8 points)
Secondary Benefits
ADCS-ADL Score58 points (Scale: 0-78, higher is better)
+5.2% (+3 points)
NPI Total Score24 points (Scale: 0-144, higher is worse)
-14.6% (-3.5 points)
Common Side Effects
Nausea
+11%
Diarrhea
+9%
Insomnia
+9%

Clinical Trial Phases:

Phase 4
4
Rivastigmine
43% Effectivenessβ€’ 88% Confidenceβ€’ 58% Safetyβ€’ 55 trialsβ€’ 20K participants
HIGH EvidenceExcellent ValueDose: 1.5-6 mg orally twice daily, or 4.6-13.3 mg/24h transdermal patch
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
MethπŸ’€
Cigarettes🚬
Chemo☒️
Alcohol🍺
MorphineπŸ’Š
AntibioticsπŸ’‰
TylenolπŸ’Š
ExerciseπŸƒ
WaterπŸ’§
58
DangerousModerateSafe

Time to Effect

4-6 weeks

Duration

Lifetime

Response Rate

25%

Remission Rate

%

Number Needed to Treat (NNT)

10

Number Needed to Harm (NNH)

15

Common Side Effects:

Nausea: 10%
Vomiting: 7%
Skin irritation (patch): 12%
Diarrhea: 4%
Dizziness: 6%

Annual Cost of Care

Drug Cost

$150

Monitoring

$400

Side Effects

$50

Total Annual

$600

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.04

Cost per Responder

$2,400

Treatment Outcomes
Primary Outcomes
ADAS-Cog (Alzheimer's Disease Assessment Scale-Cognitive Subscale)25 points (ADAS-Cog scale: 0-75, higher score indicates worse cognitive function)
-8% (-2 points (lesser decline or improvement in score compared to placebo))
CIBIC-Plus (Clinician's Interview-Based Impression of Change Plus Caregiver Input)4 (CIBIC-Plus scale: 1-7, 1=markedly improved, 4=no change, 7=markedly worse)
-7.5% (-0.3 points (less decline or slight improvement compared to placebo's change))
ADCS-ADL (Alzheimer's Disease Cooperative Study-Activities of Daily Living)60 points (ADCS-ADL scale: 0-78, higher score indicates better functional ability)
+3.3% (+2 points (lesser decline or improvement in functional ability compared to placebo))
Secondary Benefits
NPI (Neuropsychiatric Inventory)15 points (NPI scale: 0-144, higher score indicates more severe neuropsychiatric symptoms)
-20% (-3 points (reduction in neuropsychiatric symptoms compared to placebo))
Caregiver Burden (hypothetical scale, e.g., Zarit Burden Interview)25 points (Caregiver Burden Scale: 0-88, higher score indicates greater burden)
-20% (-5 points (reduction in caregiver burden due to improved patient symptoms))
Common Side Effects
Nausea
+10%
Vomiting
+7%
Skin irritation (patch)
+12%

Clinical Trial Phases:

Phase 4
5
Galantamine
42% Effectivenessβ€’ 85% Confidenceβ€’ 58% Safetyβ€’ 58 trialsβ€’ 15K participants
HIGH EvidenceExcellent ValueDose: 8-24 mg orally daily (extended-release)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
MethπŸ’€
Cigarettes🚬
Chemo☒️
Alcohol🍺
MorphineπŸ’Š
AntibioticsπŸ’‰
TylenolπŸ’Š
ExerciseπŸƒ
WaterπŸ’§
58
DangerousModerateSafe

Time to Effect

4-6 weeks

Duration

Lifetime

Response Rate

25%

Remission Rate

%

Number Needed to Treat (NNT)

12

Number Needed to Harm (NNH)

18

Common Side Effects:

Nausea: 13%
Vomiting: 8%
Anorexia: 7%
Diarrhea: 6%
Dizziness: 6%

Annual Cost of Care

Drug Cost

$100

Monitoring

$400

Side Effects

$50

Total Annual

$550

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.03

Cost per Responder

$2,200

Treatment Outcomes
Primary Outcomes
ADAS-Cog (Alzheimer's Disease Assessment Scale-Cognitive Subscale)28/70 points
-10.71% (-3 points)
MMSE (Mini-Mental State Examination)20/30 points
+6% (+1.2 points)
CIBIC-Plus (Clinician's Interview-Based Impression of Change Plus Caregiver Input)4/7 points (no change)
-10% (-0.4 points)
Secondary Benefits
ADCS-ADL (Alzheimer's Disease Cooperative Study - Activities of Daily Living)55/78 points
+3.64% (+2 points)
NPI (Neuropsychiatric Inventory)25/144 points
-12% (-3 points)
CDR-SB (Clinical Dementia Rating - Sum of Boxes)7/18 points
-7.14% (-0.5 points)
Common Side Effects
Nausea
+13%
Vomiting
+8%
Anorexia
+7%

Clinical Trial Phases:

Phase 4
6
Memantine
40% Effectivenessβ€’ 85% Confidenceβ€’ 68% Safetyβ€’ 73 trialsβ€’ 12K participants
HIGH EvidenceExcellent ValueDose: 5-20 mg orally daily
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
MethπŸ’€
Cigarettes🚬
Chemo☒️
Alcohol🍺
MorphineπŸ’Š
AntibioticsπŸ’‰
TylenolπŸ’Š
ExerciseπŸƒ
WaterπŸ’§
68
DangerousModerateSafe

Time to Effect

2-4 weeks

Duration

Lifetime

Response Rate

25%

Remission Rate

%

Number Needed to Treat (NNT)

10

Number Needed to Harm (NNH)

25

Common Side Effects:

Dizziness: 7%
Headache: 6%
Confusion: 5%
Constipation: 5%

Annual Cost of Care

Drug Cost

$100

Monitoring

$400

Side Effects

$50

Total Annual

$550

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.03

Cost per Responder

$2,200

Treatment Outcomes
Primary Outcomes
ADAS-Cog Score (Cognitive Function)28/70 points
-5.3% (-1.5 points)
ADCS-ADL Score (Activities of Daily Living)45/78 points
+2.2% (+1.0 point)
NPI Score (Neuropsychiatric Symptoms)30/144 points
-16.7% (-5.0 points)
Secondary Benefits
Zarit Burden Interview Score (Caregiver Burden)35/88 points
-8.6% (-3.0 points)
MMSE Score (Mini-Mental State Examination)15/30 points
+3.3% (+0.5 points)
CMAI Score (Agitation)60/203 points
-6.7% (-4.0 points)
Common Side Effects
Dizziness
+7%
Headache
+6%
Confusion
+5%

Clinical Trial Phases:

Phase 4