{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T10:26:19Z","timestamp":1794306379335,"version":"4.9.0"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:p>Alzheimer\u2019s disease (AD) affects over 6 million people over the age of 65. The advent of new anti-amyloid monoclonal antibodies as treatment for early Alzheimer\u2019s disease these immunotherapeutics may slow disease progression but also pose significant risks. Amyloid related imaging abnormalities (ARIA) identified on MRI following administration of these new monoclonal antibodies can cause both brain edema (ARIA-E) and hemorrhage (ARIA-H). While most ARIA is asymptomatic, some patients can develop headache, confusion, nausea, dizziness, seizures and in rare cases death. By analyzing lecanemab, aducanumab, gantenerumab, donanemab, and bapineuzumab clinical trials; risk factors for developing ARIA can be identified to mitigate some of the ARIA risk. Risk factors for developing ARIA-E are a positive Apo\u03b54 carrier status and prior multiple cerebral microhemorrhages. Risk factors for ARIA-H are age, antithrombotic use, and history of prior strokes. With lecanemab, ARIA-E and ARIA-H were seen at lower rates 12 and 17%, respectively, compared to aducanumab (ARIA-E 35% and ARIA-H 19%) in treated patients. ARIA risk factors have impacted inclusion and exclusion criteria, determining who can receive lecanemab. In some clinics, almost 90% of Alzheimer\u2019s patients are excluded from receiving these new anti-amyloid therapeutics. This review aims to discuss risk factors of ARIA and highlight important areas for further research. With more anti-amyloid monoclonal antibodies approved by the Food and Drug Administration, considering patient risk factors for developing ARIA is important to identify to minimize patient\u2019s risk while receiving these new therapies.<\/jats:p>","DOI":"10.3389\/fnins.2024.1326784","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T23:17:37Z","timestamp":1705619857000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":139,"title":["Risk factors in developing amyloid related imaging abnormalities (ARIA) and clinical implications"],"prefix":"10.3389","volume":"18","author":[{"given":"Sarah J.","family":"Doran","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell P.","family":"Sawyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e230009","DOI":"10.1148\/rg.230009","article-title":"Amyloid-related imaging abnormalities in Alzheimer disease treated with anti-amyloid-\u03b2 therapy","volume":"43","author":"Agarwal","year":"2023","journal-title":"Radiographics"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1002\/alz.12638","article-title":"2022 Alzheimer\u2019s disease facts and figures","volume":"18","year":"2022","journal-title":"Alzheimers Dement."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"E1809","DOI":"10.1212\/WNL.0000000000012778","article-title":"Spontaneous ARIA-like events in cerebral amyloid angiopathy\u2013related inflammation a multicenter prospective longitudinal cohort study","volume":"97","author":"Antolini","year":"2021","journal-title":"Neurology"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1136\/jnnp-2014-309493","article-title":"Amyloid-related imaging abnormalities-haemosiderin (ARIA-H) in patients with Alzheimer\u2019s disease treated with bapineuzumab: a historical, prospective secondary analysis","volume":"87","author":"Arrighi","year":"2016","journal-title":"J. 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