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# Lecanemab in real-world practice: pooled ARIA, discontinuation and cognitive outcomes
- URL: https://www.coios.me/lecanemab-in-real-world-practice-pooled-aria/
- Published: 2026-10-23T13:05:21.000Z
- Updated: 2026-10-23T17:02:21.000Z
- Description: Any ARIA occurred in 15.1% of lecanemab-treated patients in real-world cohorts, rising to 34.1% in APOE e4 homozygotes.
- Author: Daniel Ryan
- Tags: Health today, Dementia, World, #peer-reviewed, #refines, #item, #source-2026-10, #score-65

This meta-analysis pooled thirty-seven real-world studies of lecanemab, covering ARIA, discontinuation, cognition and amyloid PET. Any ARIA was 15.1%, ARIA-E 6.5%, ARIA-H 11.5% and symptomatic ARIA 1.3%, with US rates above Asian rates. ARIA rose with APOE e4 dose, from 11.0% in non-carriers to 34.1% in homozygotes, and with baseline microhaemorrhage. Total discontinuation was 12.2%, ARIA-related discontinuation 3.5%, infusion-related reactions 18.5% and serious adverse events 2.8%. Amyloid PET fell at 6 months (-28.5 Centiloid) and 12 months (SUVR -0.171), while cognitive measures showed no significant change. The pooled cohorts had no control groups, so the authors state that efficacy cannot be inferred.

*Why it is interesting: The review gives ARIA incidence in routine practice, stratified by APOE genotype and baseline microbleeds. Amyloid reduction is recorded, but the uncontrolled design leaves any cognitive effect unresolved.*

Source

[Journal of Neurology, 22 October 2026](https://doi.org/10.1007/s00415-026-14224-y?ref=coios.me)

Paper

Real-world safety and efficacy of lecanemab in the treatment of Alzheimer's disease: a systematic review and meta-analysis

Authors

Wu Y, Zhu L, Chen J, Liu J, Yin K, Yang X

DOI

10.1007/s00415-026-14224-y

Type

Peer-reviewed article

Design

Systematic review and random-effects meta-analysis of 37 real-world lecanemab studies, searched to October 2026, with subgroup and leave-one-out sensitivity analyses

Verdict

Refines prior evidence

Driver

[Dementia](https://www.coios.me/d-dementia/)