Rationale for Correct Answer
The correct answer is: The association between increased ARIA risk and ApoE status is seen with all amyloid-lowering medications evaluated thus far
The association between increased ARIA risk and ApoE status is seen with all amyloid-lowering medications evaluated thus far.1,2,3 ARIA-E and ARIA-H are more common in ApoE4 carriers, with the risk being much higher in homozygotes than in heterozygotes.1 About 74% of radiographically identified ARIA is asymptomatic.4
If they meet the recommendations, patients who are ApoE4 heterozygotes should receive amyloid-lowering therapy. However, they require more careful monitoring. ARIA tends to occur within the first several weeks or months of treatment, with variation depending on the drug and dosing schedule. Determining amyloid status is recommended before starting anti-Aβ antibodies and is needed for informed consent.1
References:
1. Salloway S et al. JAMA Neurology 2022;79:13-21.
2. Van Dyck CH et al. New Engl J Med. 2023;388:9-21.
3. Mintun MA et al. N Engl J Med. 2021;384:1691-1704.
4. Cummings J et al. J Prev Alz Dis 2021;8:398-410.