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when the drug is shown to have an effect on a surrogate endpoint that is reasonably likely to predict a clinical benefit to patients and there remains some uncertainty about the drug's clinical benefit.

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In this case the surrogate endpoint is a reduction in plaque. There is not a proven correlation between plaque reduction and positive effect on Alzheimer's disease.

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In surprising twist, some Alzheimer's plaques may be protective, not destructive

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https://www.sciencedaily.com/releases/2021/04...114143.htm