A class of drugs meant to slow the cognitive decline of Alzheimer's disease, including one that appears to have real but modest benefits, can cause brain shrinkage, a new analysis shows. Although scientists and drug developers have documented brain volume loss in trials of the drugs for years, the scientific review, published last week in Neurology, is the first to look at data across numerous studies. It also links the brain shrinkage to a better known side effect of the drugs, brain swelling. "We don't fully know what these changes might imply," says Jonathan Jackson, a cognitive neuroscientist at Massachusetts General Hospital. But, he says, "It's likely these changes are detrimental." They cast a shadow on the promise of one drug, the antibody lec-anemab, which was granted accelerated approval in the United States in January after a trial showed it slowed the rate of cognitive decline by 27% after 18 months compared with people on a placebo.
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