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En respuesta a «Avances y controversias de los tratamientos de la enfermedad de Alzheimer»
Víctor Manuel González-Rodríguez, Esther Martín-López. Atención Primaria, 2026-07-13
Topic: Amyloid, tau and blood-test diagnosis
controversias de los tratamientos de la enfermedad de Alzheimer» In response to 'Advances and controversies in the treatments of Alzheimer's disease' Sr. Editor, Felicitamos a la Dra.M. J. González Moneo por abordar un tema de gran relevancia en atención primaria 1 .Nos gustaría añadir algunas precisiones que podrían servir para contestar las dudas de nuestros pacientes.En primer lugar, no existe demostración clínica sólida de que los anticuerpos anti--amiloide modifiquen la progresión de la enfermedad de Alzheimer.Una revisión Cochrane concluye que, tras 18 meses de tratamiento, estos anticuerpos aportan «poca o ninguna diferencia» en la gravedad de la demencia 2 .Dicho efecto se considera clínicamente insignificante, pues las mejoras cognitivas medidas en escalas (p.ej.CDR-SB o ADAS-Cog) son mínimas.Es importante recordar que la fisiopatología de la enfermedad de Alzheimer es multifactorial y que la hipótesis amiloide, por sí sola, no parece explicar la complejidad del síndrome.Por otra parte, el perfil de seguridad de los fármacos anti-amiloides ensayados plantea preocupación.El mismo metaanálisis evidencia un notable aumento de anomalías amiloides relacionadas con el tratamiento (ARIA): 119 de cada 1.000 pacientes desarrollaron inflamación cerebral (ARIA-E) frente a 12/1.000con placebo, además de un incremento de microhemorragias (ARIA-H).Nuestros pacientes deben conocer estos riesgos, que requieren seguimiento con resonancias periódicas y administración en entornos hospitalarios controlados para vigilar también las frecuentes reacciones relacionadas con la infusión.Ese modelo de atención incrementaría la carga asistencial de profesionales y centros sanitarios.Implicaría un aumento del tiempo y desplazamientos requeridos a pacientes y cuidadores, lo que se traduciría en un impacto negativo relevante sobre la equidad en el acceso a la atención sanitaria y la sostenibilidad del sistema para el uso de tratamientos con beneficio clínico de baja magnitud y relevancia clínica cuestionable.Los ensayos disponibles tienen limitaciones.Se basan en un único estudio pivotal (p.ej.CLARITY-AD para lecanemab) con criterios muy restrictivos, lo que reduce su validez
Key findings
- controversias de los tratamientos de la enfermedad de Alzheimer» In response to 'Advances and controversies in the treatments of Alzheimer's disease' Sr.
- González Moneo por abordar un tema de gran relevancia en atención primaria 1 .Nos gustaría añadir algunas precisiones que podrían servir para contestar las dudas de nuestros pacientes.En primer lugar, no existe demostración clínica sólida de que los anticuerpos anti--amiloide modifiquen la progresi
Why it matters
This letter states there is no solid clinical demonstration that anti-amyloid antibodies change the progression of Alzheimer's disease, citing a Cochrane review finding little or no difference in dementia severity after 18 months. It also raises safety concerns, noting a marked increase in ARIA, with 119 of every 1,000 patients developing brain inflammation (ARIA-E) versus 12 per 1,000 on placebo, plus more microhemorrhages (ARIA-H).
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Study details
- Evidence strengthLow
How this study scored 29/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 28 of the 96 points we could judge it on, which is 29 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Atención Primaria) |
| Journal's citation record | 0 / 4 | Atención Primaria: journal h-index 56 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” 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 | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Esther Martín-López holds only 3 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 0 / 3 | Universidad de Salamanca: institution h-index 432 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42435702) |
| Free to read | 2 / 2 | Free to read |
| Points | 28 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 28 of the 96 points we could judge it on is 29 out of 100. |
| Total | 29 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1016/j.aprim.2026.103570
- PubMed: 42435702
- Original source →
- Free full text: Atención Primaria →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
González-Rodríguez, V. M., & Martín-López, E. (2026). En respuesta a «Avances y controversias de los tratamientos de la enfermedad de Alzheimer». Atención Primaria. https://doi.org/10.1016/j.aprim.2026.103570
Vancouver
González-Rodríguez VM, Martín-López E. En respuesta a «Avances y controversias de los tratamientos de la enfermedad de Alzheimer». Atención Primaria. 2026. doi:10.1016/j.aprim.2026.103570. PMID: 42435702.
BibTeX
@article{gonzalezrodriguez2026-42435702,
author = {González-Rodríguez, Víctor Manuel and Martín-López, Esther},
title = {{En respuesta a «Avances y controversias de los tratamientos de la enfermedad de Alzheimer»}},
journal = {Atención Primaria},
year = {2026},
doi = {10.1016/j.aprim.2026.103570},
pmid = {42435702},
url = {https://doi.org/10.1016/j.aprim.2026.103570}
}
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