Vessels Sing Their ARIAs: The Role of Vascular Amyloid in the Age of Aducanumab

Author:

Sveikata Lukas12ORCID,Charidimou Andreas1,Viswanathan Anand1ORCID

Affiliation:

1. J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston (L.S., A.C., A.V.).

2. Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Switzerland (L.S.).

Abstract

We review the implications of the recently approved aducanumab amyloid-β immunotherapy for treating Alzheimer disease with comorbid cerebral amyloid angiopathy. In clinical trials, amyloid-β immunotherapy has been associated with a high rate of amyloid-related imaging abnormalities, potentially driven by coexisting cerebral amyloid angiopathy. Therefore, immunotherapy’s efficacy in patients may be modified by coexisting cerebrovascular pathology. We discuss the contributions of cerebral amyloid angiopathy on the development of amyloid-related imaging abnormalities and propose strategies to identify cerebral amyloid angiopathy in patients considered for immunotherapy.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

Reference24 articles.

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2. Haeberlein SB Hehn C von Tian Y Chalkias S Muralidharan KK Chen T Wu S Li J Skordos L Nisenbaum Let al. EMERGE and ENGAGE Topline Results: Two Phase 3 Studies to Evaluate Aducanumab in Patients With Early Alzheimer’s Disease [Internet]. 2019 [cited 2021 Jun 9]; Available from: https://investors.biogen.com/static-files/8e58afa4-ba37-4250-9a78-2ecfb63b1dcb

3. Biogen. Biogen and Eisai to Discontinue Phase 3 ENGAGE and EMERGE Trials of aducanumab in Alzheimer’s Disease. Biogen [Internet]. https://investors.biogen.com/news-releases/news-release-details/biogen-and-eisai-discontinuephase-3-engage-and-emerge-trials.

4. Food and Drug Administration. Aduhelm. Highlights of Prescribing Information [Internet]. 2021 [cited 2021 Sep 1];Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/761178s003lbl.pdf

5. Off-label use of aducanumab for cerebral amyloid angiopathy.;Greenberg SM;Lancet Neurol,2021

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