From a mouse: systematic analysis reveals limitations of experiments testing interventions in Alzheimer's disease mouse models

The increasing prevalence of Alzheimer's disease (AD) poses a considerable socio‐economic challenge. Decades of experimental research have not led to the development of effective disease modifying interventions. A deeper understanding of in vivo research might provide insights to inform future in vivo research and clinical trial design. We therefore performed a systematic review and meta‐analysis of interventions tested in transgenic mouse models of AD. We searched electronically for publications testing interventions in transgenic models of AD. We extracted data for outcome, study characteristics and reported study quality and calculated summary estimates of efficacy using random effects meta‐analysis. We identified 427 publications describing 357 interventions in 55 transgenic models, involving 11,118 animals in 838 experiments. Of concern, reported study quality was relatively low; fewer than one in four publications reported the blinded assessment of outcome or random allocation to group and no study reported a sample size calculation. Additionally, there were few data for any individual intervention—only 16 interventions had outcomes described in 5 or more publications. Finally, “trim and fill” analyses suggested one in seven pathological and neurobehavioural experiments remain unpublished. Given these historical weaknesses in the in vivo modelling of AD in transgenic animals and the identified risks of bias, clinical trials that are based on claims of efficacy in animals should only proceed after a detailed critical appraisal of those animal data.