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Peer-reviewedCC BY-NCAlzheimer's & dementia (Amsterdam, Netherlands)

Topography and risk factors of amyloid-related imaging abnormality: real-world data from 168 aducanumab-treated patients at a private clinic in South Korea.

  • Soyeon Yoon1,2
  • Jehyun Ahn1,2
  • Seongmi Kim1,2
  • Kyoungmin Kim1,2
  • Sin Young Kim3
  • Seo Kyung An3
  • Dong Gyu Na4,5
  • Young Ju Kim6
  • Kichang Kwak6
  • Sang Won Seo1,2,6
  • Duk L Na1,2,3
6 affiliations
  1. 1Alzheimer's Disease Convergence Research Center Samsung Medical Center Seoul Republic of Korea.
  2. 2Department of Neurology Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul Republic of Korea.
  3. 3Happymind Clinic Seoul Republic of Korea.
  4. 4Human Medical Imaging and Intervention Center Seoul Republic of Korea.
  5. 5Department of Radiology Gangneung Asan Hospital University of Ulsan College of Medicine Gangneung Republic of Korea.
  6. 6Beaubrain Healthcare Inc. Seoul Republic of Korea.
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Abstract

Introduction

Amyloid-related imaging abnormalities (ARIA) are a major safety concern in anti-amyloid therapy for Alzheimer's disease (AD), but real-world data remain limited. We investigated risk factors, temporal characteristics, and spatial distribution of ARIA in aducanumab-treated patients and assessed the safety of apolipoprotein E (APOE) genotype-tailored dosing.Methods

We retrospectively analyzed 168 patients with a Clinical Dementia Rating (CDR) of 0.5 to 2 treated with aducanumab between 2022 and 2024. Dosing was individualized by APOE genotype. Serial magnetic resonance imaging (MRI) detected ARIA, multivariable regression identified risk factors, and ARIA with edema or effusion (ARIA-E) lesions were manually segmented to generate topographical maps.Results

Among 164 patients, 33 (20.1%) developed ARIA-E, with incidence increasing by APOE ε4 status (12.5% non-carriers, 19.5% heterozygotes, 50.0% homozygotes; p = 0.002). Lesions showed posterior predominance. Independent risk factors included APOE ε4 homozygosity, CDR 2, and hypertension. Most cases did not require treatment discontinuation.Discussion

ARIA-E risk during aducanumab therapy was influenced by genetic and clinical factors, supporting genotype-tailored titration in practice.

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Cite

BibTeXRIS
BibTeX
@article{yoon2026topography,
  title = {{Topography and risk factors of amyloid-related imaging abnormality: real-world data from 168 aducanumab-treated patients at a private clinic in South Korea.}},
  author = {Soyeon Yoon and Jehyun Ahn and Seongmi Kim and Kyoungmin Kim and Sin Young Kim and Seo Kyung An and Dong Gyu Na and Young Ju Kim and Kichang Kwak and Sang Won Seo and Duk L Na},
  journal = {Alzheimer's \& dementia (Amsterdam, Netherlands)},
  year = {2026},
  month = oct,
  doi = {10.1002/dad2.70473},
  url = {https://europepmc.org/article/MED/42908770},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Topography and risk factors of amyloid-related imaging abnormality: real-world data from 168 aducanumab-treated patients at a private clinic in South Korea.
AU  - Soyeon Yoon
AU  - Jehyun Ahn
AU  - Seongmi Kim
AU  - Kyoungmin Kim
AU  - Sin Young Kim
AU  - Seo Kyung An
AU  - Dong Gyu Na
AU  - Young Ju Kim
AU  - Kichang Kwak
AU  - Sang Won Seo
AU  - Duk L Na
PY  - 2026
DA  - 2026/10/20
JO  - Alzheimer's & dementia (Amsterdam, Netherlands)
DO  - 10.1002/dad2.70473
UR  - https://europepmc.org/article/MED/42908770
AB  - Introduction  Amyloid-related imaging abnormalities (ARIA) are a major safety concern in anti-amyloid therapy for Alzheimer's disease (AD), but real-world data remain limited. We investigated risk factors, temporal characteristics, and spatial distribution of ARIA in aducanumab-treated patients and assessed the safety of apolipoprotein E (APOE) genotype-tailored dosing.Methods  We retrospectively analyzed 168 patients with a Clinical Dementia Rating (CDR) of 0.5 to 2 treated with aducanumab between 2022 and 2024. Dosing was individualized by APOE genotype. Serial magnetic resonance imaging (MRI) detected ARIA, multivariable regression identified risk factors, and ARIA with edema or effusion (ARIA-E) lesions were manually segmented to generate topographical maps.Results  Among 164 patients, 33 (20.1%) developed ARIA-E, with incidence increasing by APOE ε4 status (12.5% non-carriers, 19.5% heterozygotes, 50.0% homozygotes; p = 0.002). Lesions showed posterior predominance. Independent risk factors included APOE ε4 homozygosity, CDR 2, and hypertension. Most cases did not require treatment discontinuation.Discussion  ARIA-E risk during aducanumab therapy was influenced by genetic and clinical factors, supporting genotype-tailored titration in practice.
SN  - 2352-8729
ER  -