Signals
3Real-world ARIA rates from registries are landing close to trial estimates
Early registry data on lecanemab and donanemab in routine clinical use is producing ARIA incidence numbers that broadly track the pivotal trials, with APOE4 homozygotes consistently the highest-risk group.
ARIA surveillance is becoming the rate-limiting step in anti-amyloid care
Amyloid-related imaging abnormalities require protocol-defined MRI at multiple intervals, and managing positive findings demands neurologist judgment that is in short supply.
APOE4 genotype is reshaping eligibility, dosing, and disclosure
Anti-amyloid trial readouts and post-marketing surveillance both show APOE4 homozygotes face higher ARIA risk - pushing genotype testing into pre-treatment workflows.
Snapshots
1Explained
3What ARIA is, and why it gates how anti-amyloid antibodies can be used
ARIA - amyloid-related imaging abnormalities - is the side effect that defines the operational and clinical experience of being on lecanemab or donanemab. Understanding what it is, who it affects more, and why it requires MRI surveillance is essential context for any conversation about anti-amyloid treatment.
What is ARIA, and why does it matter for treatment?
Amyloid-related imaging abnormalities are the defining safety consideration of the anti-amyloid antibody class - and the reason MRI surveillance is built into treatment.
Why APOE4 matters in Alzheimer's disease and treatment
APOE4 is both the strongest common genetic risk factor for late-onset Alzheimer's and a meaningful modifier of treatment safety - which is why genotyping is now part of the workup.