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Favorable long-term cognitive outcomes following recurrent ARIA linked to amyloid-lowering therapies: two cases
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Favorable long-term cognitive outcomes following recurrent ARIA linked to amyloid-lowering therapies: two cases
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Journal Article
Favorable long-term cognitive outcomes following recurrent ARIA linked to amyloid-lowering therapies: two cases
2025
Overview
Introduction
The large-scale approval of anti-amyloid monoclonal antibodies for treating Alzheimer’s disease (AD) has raised concerns about their safety due to treatment-emergent amyloid-related imaging abnormalities (ARIA).
Methods
We present two cases of patients diagnosed with mild cognitive impairment due to AD who were enrolled in the GRADUATE I clinical trial. They received subcutaneous gantenerumab every two weeks during the study period.
Results
Both patients experienced recurrent ARIA-Effusion/Edema type (ARIA-E). One developed symptomatic and severe ARIA, leading to hospitalization and study withdrawal. We report a long follow-up post-randomization (65 and 54 months), during which the adverse events did not appear to have a negative impact on disease progression. Additionally, one patient had a negative amyloid-PET over a year after treatment cessation.
Discussion
These cases suggest that recurrent ARIA-E do not inevitably lead to accelerated progression, instead, may relate to possible long-term benefits. The mechanisms underlying these findings warrant further real-life evidence.
Publisher
Springer Berlin Heidelberg,Springer Nature B.V
Subject
Alzheimer Disease - complications
/ Alzheimer Disease - diagnostic imaging
/ Alzheimer Disease - drug therapy
/ Amyloid
/ Amyloid beta-Peptides - metabolism
/ Antibodies, Monoclonal, Humanized - adverse effects
/ Antibodies, Monoclonal, Humanized - therapeutic use
/ Cognitive Dysfunction - diagnostic imaging
/ Cognitive Dysfunction - drug therapy
/ Cognitive Dysfunction - etiology
/ Edema
/ Effusion
/ Humans
/ Medicine
/ Patients
