Titan Zachariah Alexio,1,2 Leilani Teso,2 Nya-Lynn Santos,2 Mia Ng,2 Qi Zhi,2 Michael Sonson,3 Enrique Carrazana,1 Kore Liow1,2
1 John A. Burns School of Medicine, University of Hawaiʻi, Honolulu, HI
2 Hawaii Pacific Neuroscience Memory Disorders Center and Alzheimer’s Research Unit, Honolulu, HI
3 Cedars-Sinai Medical Center, University of California, Los Angeles, Los Angeles, CA
I: Lecanemab, Aducanemab, and PRX012 are emerging monoclonal antibody treatments for early Alzheimer’s disease (AD). These drugs have shown success in prior trials, but amyloid-related imaging abnormalities (ARIA) and infusion reactions rates remain untested across diverse populations. O: To characterize the Hawaiʻi population undergoing anti-amyloid therapies in terms of risk factors, outcomes, and adverse effects. M: 25 patients were identified from the Hawaiʻi Pacific Neuroscience database with a diagnosis of early AD and at least one anti-amyloid infusion. ApoE status, MMSE scores, and MRI results were assessed. R: 18(72%) patients were diagnosed with mild cognitive impairment (MCI), compared to 7(28%) with AD. 11(65%) had the E3/E4 genotype; only 1(5.9%) was an E4/E4 homozygote. Co-morbidities included HTN (7[28%]), affecting 42% of Lecanemab patients. Regarding patient outcomes: 3/12 on Lecanemab, 2/9 on Aducanemab, and 2/4 on PRX012 had evidence of ARIA on post-infusion MRI. C: Hawaii’s unique population had a higher rate of ARIA-H than would have been expected based on published rates in the Clarity AD trial. While the population of this study was limited, further research will become more important as these drugs become increasingly accessible to distinct populations.
