Favorable long-term cognitive outcomes following recurrent ARIA linked to amyloid-lowering therapies: two cases.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY Journal of Neurology Pub Date : 2025-01-24 DOI:10.1007/s00415-025-12910-x

Matteo Zavarella, Giordano Cecchetti, Giulia Rugarli, Alma Ghirelli, Ilaria Bottale, Francesca Orlandi, Edoardo G Spinelli, Roberto Santangelo, Francesca Caso, Sonia Francesca Calloni, Paolo Quintiliano Vezzulli, Andrea Falini, Giuseppe Magnani, Federica Agosta, Massimo Filippi

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Abstract

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.

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来源期刊

Journal of Neurology 医学-临床神经学

CiteScore

10.00

自引率

5.00%

发文量

558

审稿时长

1 months

期刊介绍： The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.