COIOSDeep risk insights through multi-disciplinary research across the globe
photo of city building
Item refines Peer-reviewed Added

Lecanemab in real-world practice: pooled ARIA, discontinuation and cognitive outcomes

Any ARIA occurred in 15.1% of lecanemab-treated patients in real-world cohorts, rising to 34.1% in APOE e4 homozygotes.

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
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

Other drivers in Health today

  • Cancer

    Where is cancer incidence rising and falling, what screening and new tests find earlier, and what treatment has done to survival.

    8 this week
  • Obesity, diabetes and GLP-1

    Are obesity and diabetes still rising, what behavioural change and public policy do, and what difference do GLP-1s and other similar drugs make.

    10 this week
  • Heart and stroke

    Whether deaths from heart disease and stroke have stopped falling, what is found earlier, what treatment and prevention do now, and what the deaths say.

    4 this week
  • Mental health

    Deaths by suicide, the life expectancy gap in severe mental illness, and the physical disease that follows it: what mental illness costs in lives.

    1 this week
  • Dementia

    Whether dementia is becoming more or less common, what is now found, what treatment and prevention do, and what the deaths say.

    4 this week
  • Frailty and multimorbidity

    Whether the years added after 85 are healthy ones, how frailty and multiple conditions are measured, and where the data run out.

    2 this week