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Ischemic stroke associated with amyloid-related imaging abnormalities in a patient treated with lecanemab
Gibson AW, Elser H, Rosso M, Cornblath EJ, Fonkeu Y, Prasad S, Rothstein A, Nasrallah IM et al.. Alzheimer's & dementia : the journal of the Alzheimer's Association, 2024-08-30
Topic: Drug trials: efficacy and safety
Introduction Anti-amyloid antibody therapies such as lecanemab are increasingly being used to treat Alzheimer's disease (AD). These therapies are associated with a high rate of amyloid-related imaging abnormalities (ARIA). Methods We review the case history of a patient who developed ARIA associated with lecanemab treatment. Results In addition to microhemorrhages and cerebral edema that are recognized features of ARIA, the patient developed several ischemic strokes. The patient also experienced frequent electrographic seizures without overt clinical seizures. The patient demonstrated clinical and radiographic improvement after steroid treatment. Discussion Our case suggests that ischemic strokes may be a feature of ARIA and highlights the importance of having a high clinical suspicion for seizures in ARIA. As anti-amyloid therapies are likely going to be increasingly used to treat AD, it is important to appreciate the spectrum of clinical and radiographic findings that can result as side effects from this class of therapies. Highlights We report a patient who developed severe amyloid-related imaging abnormalities (ARIA) after treatment with lecanemab. Our report suggests that ischemic strokes may be a novel imaging feature of ARIA. Our report highlights the need for high clinical suspicion for seizures in ARIA.
Key findings
- These therapies are associated with a high rate of amyloid-related imaging abnormalities (ARIA).
- Methods We review the case history of a patient who developed ARIA associated with lecanemab treatment.
- Results In addition to microhemorrhages and cerebral edema that are recognized features of ARIA, the patient developed several ischemic strokes.
- The patient demonstrated clinical and radiographic improvement after steroid treatment.
- Discussion Our case suggests that ischemic strokes may be a feature of ARIA and highlights the importance of having a high clinical suspicion for seizures in ARIA.
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Study details
- Evidence strengthLow
How this study scored 53/100
Published in a leading specialty 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 31 of the 58 points we could judge it on, which is 53 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 | 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 | 2024 — 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 39215494) |
| Free to read | 2 / 2 | Free to read |
| Points | 31 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 31 of the 58 points we could judge it on is 53 out of 100. |
| Total | 53 / 100 | — |
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APA 7th
Gibson, A. W., Elser, H., Rosso, M., Cornblath, E. J., Fonkeu, Y., Prasad, S., et al. (2024). Ischemic stroke associated with amyloid-related imaging abnormalities in a patient treated with lecanemab. Alzheimer's & dementia : the journal of the Alzheimer's Association. https://doi.org/10.1002/alz.14223
Vancouver
Gibson AW, Elser H, Rosso M, Cornblath EJ, Fonkeu Y, Prasad S, et al. Ischemic stroke associated with amyloid-related imaging abnormalities in a patient treated with lecanemab. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2024. doi:10.1002/alz.14223. PMID: 39215494.
BibTeX
@article{gibson2024-39215494,
author = {Gibson, A. W. and Elser, H. and Rosso, M. and Cornblath, E. J. and Fonkeu, Y. and Prasad, S. and Rothstein, A. and Nasrallah, I. M. and others},
title = {{Ischemic stroke associated with amyloid-related imaging abnormalities in a patient treated with lecanemab}},
journal = {Alzheimer's \& dementia : the journal of the Alzheimer's Association},
year = {2024},
doi = {10.1002/alz.14223},
pmid = {39215494},
url = {https://doi.org/10.1002/alz.14223}
}