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A recent Cochrane review analyzing 17 clinical trials involving over 20,000 people with mild cognitive impairment or dementia has concluded that anti-amyloid drugs have a 'trivial' effect on cognition and dementia severity over 18 months.The review, which assessed seven anti-amyloid drugs, found that improvements in functional ability were 'small at best' and that the drugs caused more swelling and bleeding in the brain than the placebo.The findings are a blow to the new wave of drugs designed to slow Alzheimer's by clearing clumps of amyloid protein that build up in the brain. Despite initial hype, with some regulators approving drugs like lcanemab and donanemab, many countries have stopped short of providing them through public health services due to concerns over their effectiveness and cost.Critics of the review argue that it combines results from older, failed drugs with those from newer, more effective medicines, which may skew the conclusions. However, the review's authors defend their approach, stating that all the drugs aimed to remove amyloid from the brain and assessed the impact on patients in a similar way.The review's lead author, Edo Richard, notes that the effect sizes are too small for patients and caregivers to notice, and that the drugs are also 'burdensome' due to the need for regular intravenous drug infusions and MRI scans.Experts in the field, such as Robert Howard, express concerns that the drugs may not truly alter the course of Alzheimer's, and that it's unfair to raise expectations in patients. Meanwhile, Alzheimer's Research UK argues that the review's conclusions are limited by its methodology and that anti-amyloid treatments will not be the whole answer to curing Alzheimer's.

The Royal Shakespeare Company's upcoming production of Bertolt Brecht's 'The Resistible Rise of Arturo Ui' offers a timely warning against the rise of fascism, echoing current events in Britain and the US. The play, a satire about the rise of Hitler, features Mark Gatiss as Arturo Ui and music by the alternative rock band Placebo.Gatiss notes that the rhetoric used by Arturo Ui is 'the same rhetoric today', describing it as 'really frightening'. The play's themes of corruption, violence, and the dangers of unchecked power are as relevant today as they were when Brecht wrote the play in 1941.The production features a unique blend of music and theatre, with Placebo's Brian Molko and Stefan Olsdal creating a score that captures the brutality and urgency of the play. The music is designed to be 'loud and abrasive', with Molko describing the process of creating the score as 'like being in a dark room and feeling your way around'.Gatiss, who has a history of playing villains, says that he has put a moratorium on playing characters akin to Sherlock's Mycroft Holmes, but was drawn to the role of Arturo Ui after seeing a production at Darlington Civic Theatre with Robin Askwith in the lead. The play's director, Seán Linnen, encouraged the cast to experiment and find new ways to bring the play to life.The production's themes and message are particularly relevant in today's world, with Gatiss stating that 'we feel helpless' in the face of rising fascism. The play's epilogue, which calls on the audience to act against the rise of fascism, still gives Gatiss 'goosebumps'. As Gatiss notes, 'you have to do something. Go down swinging, at least.'