Risk of amyloid-related imaging abnormalities associated with anticoagulant therapy in patients with Alzheimers disease treated with anti-amyloid monoclonal antibodies: a systematic review and meta-analysis

Schlemm, E., Gauthier, S., Magnus, T., Thomalla, G., Rosa-Neto, P., Woo, M. S. — 2026-03-13T00:45:27-07:00

Introduction

Anti-amyloid monoclonal antibodies have emerged as a disease-modifying treatment option in early Alzheimer’s disease (AD). In patients receiving anti-amyloid immunotherapy, Aβ removal-associated blood-brain barrier damage and perivascular inflammation may present as amyloid-related imaging abnormalities (ARIA) or intracerebral haemorrhage (ICH). Based on theoretical and empirical concerns that ARIA might be more common and more severe in patients receiving oral anticoagulants, current recommendations caution against the combination of oral anticoagulants and anti-amyloid antibodies.1 2 In the European Union (EU) and UK, anti-amyloid antibody therapies are not authorised for patients receiving anticoagulants.

Considering the high prevalence of cardiovascular comorbidities in patients with AD and the crucial role of anticoagulation in the prevention of ischaemic stroke in patients with atrial fibrillation, we conducted a systematic review and meta-analysis of the risk of ARIA associated with anticoagulant use in patients with AD receiving anti-amyloid therapies.

Methods...

Frequent co-occurrence of AChR-positive myasthenia gravis in facioscapulohumeral muscular dystrophy suggests a novel disease association

2026-03-13T00:45:27-07:00

Facioscapulohumeral muscular dystrophy (FSHD) is a common inherited muscle disorder (prevalence 5–12/100 000) caused by epigenetic derepression of the normally silenced DUX4 gene.1 It produces progressive weakness of facial, shoulder girdle and later limb muscles, with no current targeted therapy. Myasthenia gravis (MG), in contrast, is an autoimmune neuromuscular junction disorder most often due to antiacetylcholine receptor (AChR) antibodies, causing fatigable weakness that typically affects extraocular, bulbar, respiratory and proximal limb muscles. MG is treatable but requires timely recognition to prevent life-threatening crises and has a UK prevalence of 10–20/100 000.2 Although both conditions are rare, several reports describe their co-occurrence. FSHD is associated with inflammatory changes in skeletal muscle, and DUX4 is expressed in the thymus, an organ central to T cell tolerance.3 This pilot study, therefore, aimed to determine whether MG occurs more frequently in FSHD and to explore whether FSHD...

Journal of Neurology, Neurosurgery & Psychiatry PostScript

Risk of amyloid-related imaging abnormalities associated with anticoagulant therapy in patients with Alzheimers disease treated with anti-amyloid monoclonal antibodies: a systematic review and meta-analysis

Frequent co-occurrence of AChR-positive myasthenia gravis in facioscapulohumeral muscular dystrophy suggests a novel disease association