amyloid-related imaging abnormality-edema, effusions, hemorrhage or siderosis (ARIA-E, ARIA-H)
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Etiology
- anti-Alzheimer monoclonal antibodies targeting beta-amyloid
- 41% of patients receiving aducanumab 10 mg/kg* (most within the 1st 8 doses)
- 13% of patients receiving lecanemab 10 mg/kg*
* 2-3% of placebo recipients in aducanumab clinical trial with ARIA-E
* incidence dose-related[3]
Pathology
Genetics
- incidence highest in apolipoprotein E4 carriers[2]
Clinical manifestations
Radiology
- abnormalities seen on MRI neuroimaging*
- 98% resolve, 83% within 16 weeks (weeks)
Management
- glucocorticoids for severe diseast
More general terms
References
- ↑ George J Alzheimer's Drug Slows Decline, Trial Data Show. Lecanemab met primary and secondary endpoints, but was associated with adverse events. MedPage Today November 30, 2022 https://www.medpagetoday.com/neurology/alzheimersdisease/101972
van Dyck CH, Swanson CJ, Aisen P Lecanemab in Early Alzheimer's Disease. N Engl J Med 2022. Nov 29. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36449413 https://www.nejm.org/doi/full/10.1056/NEJMoa2212948 - ↑ 2.0 2.1 2.2 Salloway S, Chalkias S, Barkhof F et al Amyloid-Related Imaging Abnormalities in 2 Phase 3 Studies Evaluating Aducanumab in Patients With Early Alzheimer Disease. JAMA Neurol. 2022 Jan 1;79(1):13-21. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34807243 PMCID: PMC8609465 Free PMC article. Clinical Trial.
- ↑ 3.0 3.1 Filippi M, Cecchetti G, Spinelli EG, Vezzulli P, Falini A, Agosta F. Amyloid-Related Imaging Abnormalities and beta-Amyloid-Targeting Antibodies: A Systematic Review. JAMA Neurol. 2022 Mar 1;79(3):291-304 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35099507 Review. https://jamanetwork.com/journals/jamaneurology/fullarticle/2788269