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APOE-guided lecanemab dosing dissociates ARIA-E from ARIA-H: The K-ROAD study
Heekyoung Kang, Hyemin Jang, Jehyun Ahn, Duk L Na, Jae-Hong Lee, Eun-Joo Kim, Min Young Chun, Soo Hyun Cho et al.. Alzheimer's & dementia : the journal of the Alzheimer's Association, 2026-08
Topic: Drug trials: efficacy and safety
ARIA-E incidence was 2.0% in non-carriers and 6.2% in εε4/εε4 homozygotes (εε4/εε4-versus-non-carrier OR 3.25, versus 8.49 in Clarity AD and 8.32 in Japan post-marketing surveillance). Any ARIA-H was independently predicted by baseline cerebral microbleeds, white matter hyperintensity (WMH), age, and APOE εε4 allele dose (aORs 1.23, 1.50, 1.04, 1.75). Under genotype-guided escalation, observations are compatible with - but do not establish - attenuation of the APOE εε4-driven ARIA-E gradient, whereas ARIA-H risk reflected baseline cerebrovascular burden. These findings raise the hypothesis of a dual-axis safety framework requiring randomized confirmation.
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APA 7th
Kang, H., Jang, H., Ahn, J., Na, D. L., Lee, J.-H., Kim, E.-J., et al. (2026). APOE-guided lecanemab dosing dissociates ARIA-E from ARIA-H: The K-ROAD study. Alzheimer's & dementia : the journal of the Alzheimer's Association. https://doi.org/10.1002/alz.71765
Vancouver
Kang H, Jang H, Ahn J, Na DL, Lee J.-H, Kim E.-J, et al. APOE-guided lecanemab dosing dissociates ARIA-E from ARIA-H: The K-ROAD study. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2026. doi:10.1002/alz.71765. PMID: 42642841.
BibTeX
@article{kang2026-42642841,
author = {Kang, Heekyoung and Jang, Hyemin and Ahn, Jehyun and Na, Duk L and Lee, Jae-Hong and Kim, Eun-Joo and Chun, Min Young and Cho, Soo Hyun and others},
title = {{APOE-guided lecanemab dosing dissociates ARIA-E from ARIA-H: The K-ROAD study}},
journal = {Alzheimer's \& dementia : the journal of the Alzheimer's Association},
year = {2026},
doi = {10.1002/alz.71765},
pmid = {42642841},
url = {https://doi.org/10.1002/alz.71765}
}
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Key findings
- ARIA-E incidence was 2.0% in non-carriers and 6.2% in εε4/εε4 homozygotes (εε4/εε4-versus-non-carrier OR 3.25, versus 8.49 in Clarity AD and 8.32 in Japan post-marketing surveillance).
- Any ARIA-H was independently predicted by baseline cerebral microbleeds, white matter hyperintensity (WMH), age, and APOE εε4 allele dose (aORs 1.23, 1.50, 1.04, 1.75).
- Under genotype-guided escalation, observations are compatible with - but do not establish - attenuation of the APOE εε4-driven ARIA-E gradient, whereas ARIA-H risk reflected baseline cerebrovascular burden.
- These findings raise the hypothesis of a dual-axis safety framework requiring randomized confirmation.
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Study details
- Effect size2.0%; 6.2%; OR 3.25
- Evidence strengthHigh
How this study scored 66/100
Published in a leading specialty journal. Scored zero for study design, sample size and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and free to read, so those were left out: it earned 39 of the 59 points we could judge it on, which is 66 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Alzheimer's & dementia : the journal of the Alzheimer's Association) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (pubmed indexes it as a clinical or observational study) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 2 / 3 | PubMed indexes it as a multicentre study |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42642841) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 39 / 59 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 39 of the 59 points we could judge it on is 66 out of 100. |
| Total | 66 / 100 | — |
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