Comparative Assessment: Effectiveness and Safety of Anti-amyloid Antibodies, Neuropsychiatric Drugs and Placebo in Dementia and Cognitive Impairment: A Systematic Review, Frequentist and Bayesian Network Meta-Analyses v1

The antiamyloid antibodies (AABs) have redefined Alzheimer’s disease (AD) treatment, but their comparative value against symptomatic neuropsychiatric drugs (NPDs) is unclear, due to fragmented evidence and heterogeneous population and outcomes. To address this, we developed AlzMeta.app 2.1, a web application that allows comparing effectiveness and safety of NPDs, AABs and placebo through pairwise and frequentist and Bayesian network meta-analyses of randomized trials in AD and related dementias (18/08/2025). According to PRISMA-NMA and GRADE guidelines, we compared: (1) NPDs against placebo across multiple dementia syndromes (181 studies, 41,930 participants), and (2) AABs, NPDs, and placebo in mild cognitive impairment and mild-to-moderate AD (104 studies, 42,980 participants).