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Eligibility for anti-amyloid treatment in a multiethnic community-based study
Trudel L, Therriault J, Macedo AC, Meeker KL, Braskie MN, Toga AW, Gauthier S, Vitali P et al.. Alzheimer's & dementia (Amsterdam, Netherlands), 2026-04-01
Topic: Amyloid, tau and blood-test diagnosis
Introduction The approval of anti-amyloid monoclonal antibodies (mAbs), including lecanemab and donanemab, represents a significant advance in disease-modifying therapies (DMTs) for early Alzheimer's disease (AD). While appropriate use recommendations (AURs) have been established to guide clinical decision-making, the proportion of individuals with cognitive impairment in real-world, multiethnic populations meeting eligibility criteria remains unknown, as do potential differences in treatment-related risks across ethnic groups. Methods We included 513 cognitively impaired individuals from the Health and Aging Brain Study-Health Disparities study, a multiethnic community-based cohort. Eligibility for lecanemab and donanemab was determined using published AUR criteria. Counts of amyloid-related imaging abnormalities were estimated based on apolipoprotein E ( APOE ) ε4 genotype and ethnicity using published incidence rates. Results Only 15% of participants met eligibility criteria for lecanemab or donanemab. Black individuals had a numerically higher estimated ARIA burden, though differences were not statistically significant. Discussion Few individuals in this community-based, multiethnic cohort met eligibility for anti-amyloid therapy, highlighting limited real-world applicability of current AURs. Highlights Only 15% of community-based individuals with MCI or dementia met eligibility criteria for lecanemab and donanemab.Black participants had numerically higher estimated ARIA cases, though not statistically significant.Current AUR criteria have limited real-world applicability across multiethnic populations.Broader inclusion criteria and real-world safety data are needed to ensure equitable, safe implementation.
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APA 7th
Trudel, L., Therriault, J., Macedo, A. C., Meeker, K. L., Braskie, M. N., Toga, A. W., et al. (2026). Eligibility for anti-amyloid treatment in a multiethnic community-based study. Alzheimer's & dementia (Amsterdam, Netherlands). https://doi.org/10.1002/dad2.70314
Vancouver
Trudel L, Therriault J, Macedo AC, Meeker KL, Braskie MN, Toga AW, et al. Eligibility for anti-amyloid treatment in a multiethnic community-based study. Alzheimer's & dementia (Amsterdam, Netherlands). 2026. doi:10.1002/dad2.70314. PMID: 42255958.
BibTeX
@article{trudel2026-42255958,
author = {Trudel, L. and Therriault, J. and Macedo, A. C. and Meeker, K. L. and Braskie, M. N. and Toga, A. W. and Gauthier, S. and Vitali, P. and others},
title = {{Eligibility for anti-amyloid treatment in a multiethnic community-based study}},
journal = {Alzheimer's \& dementia (Amsterdam, Netherlands)},
year = {2026},
doi = {10.1002/dad2.70314},
pmid = {42255958},
url = {https://doi.org/10.1002/dad2.70314}
}
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Key findings
- Introduction The approval of anti-amyloid monoclonal antibodies (mAbs), including lecanemab and donanemab, represents a significant advance in disease-modifying therapies (DMTs) for early Alzheimer's disease (AD).
- Results Only 15% of participants met eligibility criteria for lecanemab or donanemab.
- Black individuals had a numerically higher estimated ARIA burden, though differences were not statistically significant.
- Highlights Only 15% of community-based individuals with MCI or dementia met eligibility criteria for lecanemab and donanemab.Black participants had numerically higher estimated ARIA cases, though not statistically significant.Current AUR criteria have limited real-world applicability across multiethnic populations.Broader inclusion criteria and real-world safety data are needed to ensure equitable, safe implementation.
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Study details
- Participants513
- Evidence strengthModerate
How this study scored 62/100
Published in a leading specialty journal. Scored zero for study design, effect reported and randomized / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 36 of the 58 points we could judge it on, which is 62 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Alzheimer's & dementia (Amsterdam, Netherlands)) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 2 / 4 | 513 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42255958) |
| Free to read | 2 / 2 | Free to read |
| Points | 36 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 36 of the 58 points we could judge it on is 62 out of 100. |
| Total | 62 / 100 | — |
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