GERIATRIC PSYCHIATRYPassive antiamyloid immunotherapy for Alzheimer's diseaseLoureiro, Júlia C.a; Pais, Marcos V.a; Stella, Florindoa,b; Radanovic, Marciaa; Teixeira, Antônio Lúcioc,d; Forlenza, Orestes V.a; de Souza, Leonardo Cruze,fAuthor Information aLaboratório de Neurociências LIM-27, Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo bInstituto de Biociências, Universidade Estadual Paulista (UNESP), Rio Claro cDepartment of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Texas, USA dSanta Casa BH Ensino e Pesquisa ePrograma de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG) fDepartamento de Clínica Médica, Faculdade de Medicina, UFMG, Belo Horizonte, MG, Brazil Correspondence to Leonardo Cruz de Souza, MD, PhD, Faculdade de Medicina, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190/sl 243, Belo Horizonte, MG, Brazil. Tel: +55 31 3409 8073; e-mail: firstname.lastname@example.org Current Opinion in Psychiatry: May 2020 - Volume 33 - Issue 3 - p 284-291 doi: 10.1097/YCO.0000000000000587 Buy Metrics Abstract Purpose of review Antiamyloid therapy of Alzheimer's disease tackles the overproduction and clearance of the amyloid-beta peptide (Aβ). Immunotherapeutic compounds were tested in large-scale trials. We revisit the recent literature focusing on randomized-controlled trials (RCT) using monoclonal anti-Aβ antibodies. Recent findings Forty-three articles on anti-Aβ passive immunotherapy for Alzheimer's disease were published between January 2016 and October 2019 regarding 17 RCTs: 13 phase III trials using the monoclonal antibodies bapineuzumab, solanezumab, gantenerumab, crenezumab, and aducanumab; three phase II with crenezumab and aducanumab; and one phase I trial with BAN2401. Studies resulted largely negative considering the effect of the treatment on primary and secondary outcome variables. The incidence of the most important adverse effect, amyloid-related imaging abnormalities (ARIAs) ranged between 0.2 and 22%, in treatment groups. Primary endpoints were not met in eight trials, and five trials were discontinued prior to completion. Summary Passive immunotherapy RCTs failed to show clinically relevant effects in patients with clinically manifest or prodromal dementia. The high incidence of ARIAs indicates that the risk of adverse events may outweigh the benefits of these interventions. Ongoing studies must determine the benefit of such interventions in preclinical Alzheimer's disease, addressing the effect of antiamyloid immunotherapy in samples of asymptomatic carriers of autosomal-dominant mutations related to early-onset Alzheimer's disease. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.