Trial reportThe Lancet. Neurology2025
Neuropathological changes and amyloid-related imaging abnormalities in Alzheimer's disease treated with aducanumab versus untreated: a retrospective case-control study.
Trial report in The Lancet. Neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed.
- Relapse-associated worsening in apolipoprotein E ε4 carriers with relapsing multiple sclerosis.Journal of neurology, neurosurgery, and psychiatry · 2026Article
- Passive amyloid-β immunotherapy in Alzheimer's disease: a multicellular clearance system beyond plaque removal.Molecular neurodegeneration · 2026Review
- Article
- Early binding of anti-amyloid antibodies to CAA drives complement activation, inflammation and ARIA in mice.Molecular neurodegeneration · 2026Article
- Neuropathological study of the effects of aducanumab anti-Aβ immunotherapy on patients with Alzheimer's disease.Acta neuropathologica · 2026Article
- Improving the clinical trial landscape for patients with atypical variants of Alzheimer's disease: a call to action.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Review
- Comparative performance of semi-quantitative methods for amyloid deposition in preclinical autosomal dominant Alzheimer's disease.Alzheimer's research & therapy · 2026Article
- Drug-Induced Amyloid-Related Imaging Abnormalities: A Neurovascular Perspective on Risk Assessment.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Amyloid-related imaging abnormalities (ARIA) in anti-amyloid therapies for Alzheimer's disease: An update from the Alzheimer's Association ARIA workgroup.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Review
- Amyloid-related imaging abnormalities (ARIA) in Alzheimer's disease: from pathophysiology to individualized risk assessment.Alzheimer's research & therapy · 2026Review
- In-vitro interaction studies between the amyloid PET tracer florbetaben and the amyloid-beta targeting antibodies lecanemab and donanemab on AD brain samples reveal no interferences.Alzheimer's research & therapy · 2026Article
- Early Binding of Anti-Amyloid Antibodies to CAA Drives Complement Activation, Inflammation and ARIA in Mice.bioRxiv : the preprint server for biology · 2026Article
- Review
- Anti-Aβ3-10 monoclonal antibody 7B8 improves cognitive function and protects the blood-brain barrier in APP/PS1 mice by regulating the HMGB-1/RAGE/NF-κB pathway.Frontiers in immunology · 2026Article
- Neurogenesis and neuroplasticity activities of natural products: therapeutic potential in Alzheimer's disease.Frontiers in pharmacology · 2026Review
- Missing tissue, missing data: Resolving brain volume loss caused by anti-amyloid therapies.PLoS medicine · 2026Article
- Anti-amyloid treatment in Alzheimer disease: updated implications for patients with cerebral amyloid angiopathy and other cerebrovascular conditions.Frontiers in neurology · 2026Review
- The complement cascade in Alzheimer's disease: modern implications of an ancient immune protagonist.Molecular neurodegeneration · 2025Review
- Sialic Acid in Neurodegenerative and Psychiatric Disorders: From Molecular Regulation to Targeted Nanocarrier-Based Therapy.Pharmaceutics · 2025Review
- Alzheimer's disease heterogeneity and co-pathologies: Defining novel targets, biomarkers, modalities, and research methodologies.Alzheimer's & dementia (New York, N. Y.)Review
Corrections and comments
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Authors and funding
21 authors.
Funding
Abstract
backgroundUnderstanding the neuropathological effects of amyloid β (Aβ)-targeting therapies and amyloid-related imaging abnormalities (ARIA) in Alzheimer's disease is critical for optimising treatment efficacy and patient outcomes. Comparing Aβ PET imaging with neuropathological assessments provides context for evaluating the extent of Aβ clearance and interpreting in-vivo biomarkers. We aimed to assess clinicopathological changes and ARIA-related effects in aducanumab-treated versus untreated Alzheimer's disease.
methodsThis retrospective case-control study included five aducanumab-treated participants from clinical trials conducted at the Mayo Clinic (2016-21) who underwent autopsy (2020-23). Treated participants were matched by autosomal dominant Alzheimer's disease mutation or APOE genotype, age at cognitive symptom onset, and sex to 12 untreated participants from the Mayo Clinic Alzheimer's Disease Research Center and Mayo Clinic Study of Aging cohorts in the Mayo Clinic brain bank (Jacksonville, FL, USA). Cognitive, imaging, and neuropathological outcomes were compared using descriptive analyses and Mann-Whitney U tests.
findingsAducanumab-treated participants comprised four males and one female, all carrying at least one APOE ∊4 allele, with two harbouring a PSEN1 mutation. Cumulative dosages of aducanumab ranged from 5 mg/kg to 241 mg/kg; all participants cognitively declined during treatment, and two exhibited ARIA. Reductions in [
interpretationDisproportionate Aβ clearance and ARIA-associated neuropathology localised to superficial cortical layers suggest a distinctive pattern of target engagement by aducanumab. These findings inform understanding and monitoring of similar Aβ-targeting therapies.
fundingAlzheimer Nederland, National Institute on Aging, and Alzheimer's Association.
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Registered trials
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