Radiologists must monitor novel Alzheimer's treatment side effect, says study

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A new article published in RadioGraphics examines the use of monoclonal antibody therapies for treating Alzheimer's disease and alerts physicians to be on the lookout for a potential side effect: amyloid-related imaging abnormalities (ARIA).

Primary pathophysiology of AD. The two primary lesions associated with AD are extracellular nonvascular aggregates of Aβ and intraneuronal protein inclusions secondary to aggregation of misfolded and abnormally phosphorylated protein τ . Credit: Radiological Society of North Americaexamines the use of monoclonal antibody therapies for treating Alzheimer's disease and alerts physicians to be on the lookout for a potential side effect: amyloid-related imaging abnormalities .

"FDA-approved drugs such as aducanumab, as well as upcoming newer-generation drugs, have provided an exciting new therapy focused on reducing the amyloid plaque burden in Alzheimer disease," said Amit K. Agarwal, M.B.B.S., M.D., lead author of the article and neuroradiologist at Mayo Clinic in Jacksonville, Florida.

following an inflammatory response, leading to the leakage of blood products and fluid into surrounding tissues. ARIA-E is the most common side effect of monoclonal antibody treatment. In two phase III trials, 35% of patients on the approved dose had ARIA-E. These trials also showed that most ARIA-E cases were clinically asymptomatic and that 98% were resolved at follow-up imaging. ARIA-E occurred most frequently between three and six months of treatment, with incidence sharply dropping after the first nine months.

 

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