A Bayesian Reanalysis of the Phase III Aducanumab (ADU) Trial

J Alzheimers Dis. 2022;87(3):1009-1012. doi: 10.3233/JAD-220132.

Abstract

Background: In December 2019, in light of additional blinded data, Biogen claimed efficacy of the drug Aducanumab (ADU).

Objective: We conducted a reanalysis of the phase III ADU summary statistics, focusing in particular on the Clinical Dementia Rating-Sum of Boxes.

Methods: We used a Bayesian framework to mitigate the problems of the null-hypothesis significance testing framework. In particular, we used Bayes Factor (BF) to analyze the summary statistics. The BF is the comparison of how well two hypotheses predict the data.

Results: Our results showed that the evidence for ADU efficacy is very low. The results show that the only data with a BF value in favor of the alternative hypothesis (i.e., drug efficacy) is the high-dose condition in the EMERGE trial. However, the obtained BF falls within the range of values considered anecdotal, meaning a low level of evidence.

Conclusion: We provide a clearer interpretation of the results of the clinical trials based on the Bayesian framework, as this may be useful for future development and research in the field.

Keywords: Alzheimer’s disease; bayesian statistics; clinical trial; drugs.

Publication types

  • Clinical Trial, Phase III

MeSH terms

  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Bayes Theorem
  • Humans
  • Research Design*

Substances

  • Antibodies, Monoclonal, Humanized
  • aducanumab