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71/100

✓ Peer-reviewed alzhub usefulness score 71 out of 100. Treatments

Topic: Amyloid, tau and blood-test diagnosis

Plain-language summary

Background and objectives Amyloid-related imaging abnormalities (ARIA) are key safety considerations in anti-amyloid-β (Aβ) immunotherapy. ARIA can be categorized into 2 types: ARIA characterized by edema and effusion (ARIA-E) or microhemorrhages and superficial siderosis (ARIA-H). In this study, we assessed the incidence of ARIA in phase 3 randomized controlled trials (RCTs) of anti-Aβ immunotherapy and compared the incidence among different agents and APOE ε4 carrier status. Methods PubMed and Embase databases were searched for phase 3 RCTs of anti-Aβ immunotherapy published on or before May 23, 2024. The inclusion criteria were phase 3 trials of anti-Aβ immunotherapy for mild cognitive impairment due to Alzheimer disease (AD) or mild AD dementia, with sufficient data on ARIA-E/H. The pooled incidences of ARIA and subgroup analyses according to various agents and APOE ε4 carrier status were calculated. A sensitivity analysis excluding outliers was performed. The pooled odds ratio (OR) of ARIA-E according to the APOE ε4 carrier status was also calculated. Results Nine phase 3 RCT cohorts from 8 eligible studies were identified, analyzing data from 6,315 patients. The pooled incidence of ARIA-E was 9.5% (95% CI 2.8%-27.3%), and the adjusted pooled incidence of ARIA-E was 25.5% (95% CI 20.4%-31.8%) in the sensitivity analysis. The pooled incidence of symptomatic ARIA-E was 6.7% (95% CI 3.5%-12.5%) and that of severe ARIA-E was 3.5% (95% CI 13.8%-8.4%). The pooled incidence of ARIA-H was 17.8% (95% CI 11.0%-27.5%), with the incidence of superficial siderosis was 9.3% (95% CI 6.1%-13.9%). The pooled incidence of isolated ARIA-H was 8.7% (95% CI 7.6%-10.1%). Subgroup analysis showed that homozygous APOE ε4 carriers had significantly higher odds of developing ARIA-E (OR 5.6, 95% CI 3.8-8.2, p APOE ε4 carriers also had significantly higher odds of developing ARIA-E (OR 1.9, 95% CI 1.5-2.4, p Discussion Although limited by small sample size and cohort-level data, our meta-analysis shows the adjusted pooled incidence of ARIA-E was 25.5% and the pooled incidence of ARIA-H was 17.8% in the recent phase 3 RCTs of anti-Aβ immunotherapy. Homozygous APOE ε4 carriers have a 5.6-fold higher risk of developing ARIA-E than noncarriers.

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Jeong, S. Y., Suh, C. H., Lim, J. S., Shim, W. H., Heo, H., Choi, Y., et al. (2025). Incidence of Amyloid-Related Imaging Abnormalities in Phase III Clinical Trials of Anti-Amyloid-β Immunotherapy: An Updated Meta-Analysis. Neurology. https://doi.org/10.1212/wnl.0000000000213483

Vancouver

Jeong SY, Suh CH, Lim JS, Shim WH, Heo H, Choi Y, et al. Incidence of Amyloid-Related Imaging Abnormalities in Phase III Clinical Trials of Anti-Amyloid-β Immunotherapy: An Updated Meta-Analysis. Neurology. 2025. doi:10.1212/wnl.0000000000213483. PMID: 40112274.

BibTeX

@article{jeong2025-40112274,
  author  = {Jeong, S. Y. and Suh, C. H. and Lim, J. S. and Shim, W. H. and Heo, H. and Choi, Y. and Kim, H. S. and Kim, S. J. and others},
  title   = {{Incidence of Amyloid-Related Imaging Abnormalities in Phase III Clinical Trials of Anti-Amyloid-β Immunotherapy: An Updated Meta-Analysis}},
  journal = {Neurology},
  year    = {2025},
  doi     = {10.1212/wnl.0000000000213483},
  pmid    = {40112274},
  url     = {https://doi.org/10.1212/wnl.0000000000213483}
}

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How to read this study

Design: this is a pooled review. It combines earlier studies, so it is only as good as the studies it pools. Check how many were included, whether they were similar enough to combine, and whether the authors report inconsistency between them.
Size: the record lists 6,315 participants. Ask whether that is enough for the question, and who they were.
Effect: the record reports “9.5%; 2.8%; 27.3%”. A statistically significant result can still be small in daily life.

What the evidence grade means here

This page is graded high. alzhub.org assigns the grade automatically from keywords in the abstract, not from reading the paper. High means the abstract mentions a randomized design, a meta-analysis or a systematic review. It can add at most 5 of the 100 points in the study score, and it is a label about design, not a verdict on whether the findings are true.

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Key findings

Results Nine phase 3 RCT cohorts from 8 eligible studies were identified, analyzing data from 6,315 patients.
Subgroup analysis showed that homozygous APOE ε4 carriers had significantly higher odds of developing ARIA-E (OR 5.6, 95% CI 3.8-8.2, p < 0.001) than noncarriers.
Homozygous APOE ε4 carriers have a 5.6-fold higher risk of developing ARIA-E than noncarriers.

Why it matters

This meta-analysis found that amyloid-related imaging abnormalities occur in people receiving anti-amyloid-β immunotherapy, with higher risk in APOE ε4 carriers. It reports safety risks of these treatments rather than whether they cure or prevent Alzheimer's disease.

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Study details

Study designmeta-analysis
Participants6,315
Effect size9.5%; 2.8%; 27.3%
Evidence strengthHigh

How this study scored 71/100

Published in a leading specialty journal, and it is a meta-analysis pooling many studies.

Component	Points	Why
Journal tier	9 / 10	Tier 2 — leading specialty journal (Neurology)
Journal's citation record	4 / 4	Neurology: journal h-index 525 (OpenAlex, 2026-10-29)
Study design	12 / 12	A meta-analysis pooling many studies
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	4 / 5	2025 — within 3 year(s) of the newest study here
Sample size	3 / 4	6,315 participants
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	3 / 3	Studied in people (participant count stated)
Randomized / blinded	0 / 2	A review of other studies — randomization is not credited here
Times cited	3 / 7	Cited 36 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	12.0 citations a year over 3 year(s) since 2025
Impact for its field and year	4 / 6	Cited 19.7× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	2 / 6	Cited by 4 other studies in this library
Still being cited	2 / 4	Cited 36 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author Jae‐Hong Lee: h-index 48 (OpenAlex, whole career)
Institution's track record	0 / 3	Asan Medical Center: institution h-index 552 (OpenAlex)
Multicenter collaboration	1 / 3	OpenAlex lists 3 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 40112274)
Free to read	0 / 2	Behind a paywall — scores zero
Total	71 / 100	—

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