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Favorable long-term cognitive outcomes following recurrent ARIA linked to amyloid-lowering therapies: two cases
Zavarella M, Cecchetti G, Rugarli G, Ghirelli A, Bottale I, Orlandi F, Spinelli EG, Santangelo R et al.. Journal of neurology, 2025-01-24
Topic: Amyloid, tau and blood-test diagnosis
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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APA 7th
Zavarella, M., Cecchetti, G., Rugarli, G., Ghirelli, A., Bottale, I., Orlandi, F., et al. (2025). Favorable long-term cognitive outcomes following recurrent ARIA linked to amyloid-lowering therapies: two cases. Journal of neurology. https://doi.org/10.1007/s00415-025-12910-x
Vancouver
Zavarella M, Cecchetti G, Rugarli G, Ghirelli A, Bottale I, Orlandi F, et al. Favorable long-term cognitive outcomes following recurrent ARIA linked to amyloid-lowering therapies: two cases. Journal of neurology. 2025. doi:10.1007/s00415-025-12910-x. PMID: 39853424.
BibTeX
@article{zavarella2025-39853424,
author = {Zavarella, M. and Cecchetti, G. and Rugarli, G. and Ghirelli, A. and Bottale, I. and Orlandi, F. and Spinelli, E. G. and Santangelo, R. and others},
title = {{Favorable long-term cognitive outcomes following recurrent ARIA linked to amyloid-lowering therapies: two cases}},
journal = {Journal of neurology},
year = {2025},
doi = {10.1007/s00415-025-12910-x},
pmid = {39853424},
url = {https://doi.org/10.1007/s00415-025-12910-x}
}
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Key findings
- Results Both patients experienced recurrent ARIA-Effusion/Edema type (ARIA-E).
- 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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Study details
- Evidence strengthLow
How this study scored 47/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported 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 multi-centre collaboration, so those were left out: it earned 27 of the 58 points we could judge it on, which is 47 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of neurology) |
| 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 | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 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 | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| 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 | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39853424) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 27 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 27 of the 58 points we could judge it on is 47 out of 100. |
| Total | 47 / 100 | — |
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