How the new Alzheimer’s drug works—and why the FDA is under fire for approving it

The first drug approved for the disease in 18 years, Aduhelm shows only scant benefit in clinical trials, and experts debate whether it even has the right biological target.

Since Monday, Matthew Schrag’s inbox has been flooded with emails from patients and their loved ones wondering whether to be hopeful about a new Alzheimer’s drug. Called aducanumab, the drug was granted accelerated approval earlier this week by the U.S. Food and Drug Administration. The last time the FDA approved a drug for this devastating disease was in 2003.

But Schrag, a neurologist at Vanderbilt University Medical Center in Nashville, is very unlikely to prescribe the latest therapy. “We don’t know whether it works,” he says, “and the side effects can be really substantial.”

In the U.S., Alzheimer’s disease affects more than six million adults age 65 years or older. It’s the most common cause of dementia and

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