Amyloid-Related Imaging Abnormalities (ARIA) in Anti-Amyloid Therapies for Alzheimer’s Disease
In 2011, the Alzheimer's Association Research Roundtable convened a workgroup to publish recommendations for detecting and monitoring amyloid-related imaging abnormalities (ARIA) in Alzheimer's clinical trials. ARIA is the main side effect associated with anti-amyloid therapies for Alzheimer’s disease. The term ARIA was first introduced by this workgroup and encompasses two main types: ARIA-E (edema) and ARIA-H (hemorrhage).
Since 2011, anti-amyloid therapies have received FDA approval and are beginning to enter clinical practice, underscoring the importance of informing healthcare providers and scientists about ARIA's implications in real-world settings. In response, the Alzheimer's Association convened the 2024 ARIA workgroup to discuss current knowledge, identify gaps, and provide updated recommendations for future research to meet the needs of today's scientific and clinical community.
The 2011 ARIA workgroup
In its 2011 recommendations published in Alzheimer’s & Dementia®: The Journal of the Alzheimer’s Association, the workgroup — whose members were listed as co-authors with their conflicts of interest (COIs) disclosed in the paper — outlined a framework for detecting and managing ARIA in clinical trials. Key elements of these recommendations included:
- MRI protocol minimum standards for detection of ARIA.
- Frequency and intensity of scanning protocols.
- Reading and reporting standards for interpreting MRI results.
- Thresholds for excluding participants in anti-amyloid clinical trials based on ARIA.
- Recommendations for further research into the mechanisms underlying ARIA.
The 2024 ARIA workgroup
As anti-amyloid therapies gain FDA approval and enter clinical practice, it is crucial for health care providers and researchers to grasp the implications of ARIA in both research and real-world settings. In response, the Alzheimer's Association established the 2024 ARIA workgroup, consisting of experts in the fields of basic science, neuroradiology, neurology and bioethics to discuss growth and current gaps in knowledge regarding ARIA. While the workgroup's discussions are currently ongoing, the preliminary objective is to equip the scientific and clinical community with a comprehensive understanding of the latest knowledge on ARIA, as well as recommend directions for future research.
2024 ARIA workgroup members
The 2024 ARIA workgroup — co-chaired by Maria C. Carrillo, Ph.D., Alzheimer’s Association, United States, and Ellis van Etten, M.D., Ph.D., Leiden University Medical Center, Netherlands — comprises members selected by the Alzheimer’s Association for their diverse scientific expertise, professional affiliations in Alzheimer's research and representation from various geographic regions and genders. The workgroup also includes ex officio representatives as advisors from the National Institute of Neurological Disorders and Stroke (NINDS), the National Institute on Aging (NIH) and the F-Prime Biomedical Research Initiative.
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Alireza Atri, M.D., Ph.D., Banner Sun Health Research Institute
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Tammie L.S. Benzinger, M.D., Ph.D., Washington University in St. Louis
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Francesca Bosetti*, Ph.D., Pharm.D., National Institute of Neurological Disorders and Stroke
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Maria C. Carrillo, Ph.D., Alzheimer's Association, co-chair
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Petrice M. Cogswell, M.D., Ph.D., Mayo Clinic
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Ellis van Etten, M.D., Ph.D., Leiden University Medical Center, co-chair
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Steven M. Greenberg, M.D., Ph.D., Harvard Medical School, Massachusetts General Hospital
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Joshua D. Grill, Ph.D., University of California, Irvine
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Sandra J. Hewett*, Ph.D., National Institute of Neurological Disorders and Stroke
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Costantino Iadecola, M.D., Weill Cornell Medicine
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Takeshi Iwatsubo, M.D., Ph.D., University of Tokyo
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Clifford R. Jack Jr., M.D., Mayo Clinic
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Cynthia A. Lemere, Ph.D., Harvard Medical School, Brigham and Women’s Hospital
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Simin Mahinrad, M.D., Ph.D., Alzheimer's Association
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James A.R. Nicoll, M.D., University of Southampton
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Laurie Ryan*, Ph.D., National Institute on Aging
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Stephen Salloway, M.D., Brown University
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Reisa Sperling, M.D., Harvard Medical School, Brigham and Women’s Hospital
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Stacie Weninger*, Ph.D., F-Prime Biomedical Research Initiative
*Advisory member of the workgroup
View each workgroup member's disclosures (PDF).
Contact us
Questions and concerns about the Alzheimer's Association ARIA workgroup can be directed to Simin Mahinrad, M.D., Ph.D., Director, Medical Writing at simahinrad@alz.org.