AI Article Synopsis
- - Aducanumab is the first immunotherapy approved by the FDA for lowering amyloid levels in Alzheimer's patients, but there's limited real-world data on managing its side effects, particularly amyloid-related imaging abnormalities (ARIA).
- - In a study at Butler Hospital, ARIA-E occurred in 6 out of 24 patients treated with aducanumab, all of whom were carriers of the APOE-ε4 gene, leading to varying management strategies like treatment discontinuation and temporary holding based on severity.
- - None of the patients required hospitalization or high-dose corticosteroids, and the findings support the use of existing guidelines for monitoring and managing ARIA during aducanumab treatment.
Article Abstract
Aducanumab is the first FDA-approved amyloid-lowering immunotherapy for Alzheimer's disease. There is little real-world data to guide management of amyloid-related imaging abnormalities (ARIA), a potentially serious side-effect which requires surveillance with magnetic resonance imaging. We report our experiences in managing ARIA in patients receiving aducanumab at the Butler Hospital Memory and Aging Program during the year following FDA approval. We followed the Appropriate Use Recommendations for aducanumab to guide patient selection, detection, and management of ARIA (1). ARIA-E occurred in 6 out of 24 participants treated; all APOE-ε4 carriers. Treatment was discontinued in 4 cases of moderate-severe ARIA-E, temporarily held in 1 moderate case, and dosed through in 1 mild case (mean duration = 3 months, range, 1-6 months). No participants required hospitalization or high dose corticosteroids. Participants on anticoagulation were excluded and no macrohemorrhages occurred. These data support the measured approaches to treatment outlined in the Appropriate Use Recommendations.
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| http://dx.doi.org/10.14283/jpad.2023.96 | DOI Listing |
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