RESUMEN

Aducanumab is the first FDA-approved amyloid-lowering immunotherapy for Alzheimer's disease. There is little real-world data to guide management of amyloid-related imaging abnormalities (ARIA), a potentially serious side-effect which requires surveillance with magnetic resonance imaging. We report our experiences in managing ARIA in patients receiving aducanumab at the Butler Hospital Memory and Aging Program during the year following FDA approval. We followed the Appropriate Use Recommendations for aducanumab to guide patient selection, detection, and management of ARIA (1). ARIA-E occurred in 6 out of 24 participants treated; all APOE-ε4 carriers. Treatment was discontinued in 4 cases of moderate-severe ARIA-E, temporarily held in 1 moderate case, and dosed through in 1 mild case (mean duration = 3 months, range, 1-6 months). No participants required hospitalization or high dose corticosteroids. Participants on anticoagulation were excluded and no macrohemorrhages occurred. These data support the measured approaches to treatment outlined in the Appropriate Use Recommendations.

Asunto(s)

Enfermedad de Alzheimer , Humanos , Enfermedad de Alzheimer/diagnóstico por imagen , Enfermedad de Alzheimer/tratamiento farmacológico , Anticuerpos Monoclonales Humanizados/efectos adversos , Amiloide , Imagen por Resonancia Magnética

RESUMEN

This study examined the relationship of compliance and grip strength return 6 weeks post-carpal tunnel release surgery on a sample of 11 factory workers residing in the midwest. The percent difference between pre-operative and post-operative grip strengths was - 6.00%. An ANOVA ruled out age as a significant factor in grip strength return (F=1.20, P=0.351). A two sample t-test for gender differences in return of grip strength proved insignificant as well (t=1.01, P=0.351). The low negative correlation between participant self-report of compliance and percent difference of grip strength was - 0.426. Work was reported as the most significant barrier to compliance. Results of this study suggested that 6 weeks of occupational therapy may not be sufficient for recovery to pre-operational grip strength status. Participants with the greatest amount of compliance in combination with returning to work soon after surgery demonstrated the weakest grip strength. This result implied that the exercise program in association with returning to work may have been too strenuous. Return to work and resulting work demands should be taken into consideration when prescribing home exercise programs. These conclusions are to be considered tentative and cannot be generalized because of the small sample size used to generate the data in this study.