How to Treat ARIA in Emergency Settings: Timely Communication with Multi-Disciplinary Colleagues

This activity is part of a series


Nicolas Villain, MD, PhD
Associate Professor of Neurology
Sorbonne University
Institute of Memory and Alzheimer’s Disease
Department of Neurology
Pitié-Salpêtrière Hospital
Assistance Publique – Hôpitaux de Paris
Paris, France
Nicolas Villain, MD, PhD

Nicolas Villain, MD, PhD, is a tenured Associate Professor of Neurology at Sorbonne University, Paris, France and a cognitive and behavioral neurologist at the Institute of Memory and Alzheimer’s Disease, Department of Neurology, Pitié-Salpêtrière Hospital, Paris. He trained as an MD and a clinical fellow in Paris in Prof. Bruno Dubois’ group and carried out his PhD with Dr. Gaël Chételat in Caen, France, where he worked on multimodal neuroimaging and disconnection mechanisms in Alzheimer’s disease. He currently leads projects on brain network vulnerability using multimodal neuroimaging and on fluid biomarkers of Alzheimer’s disease in Prof. Kaj Blennow’s new group at the Paris Brain Institute.

Karen Greenberg, DO, DO, FACOEP-D, FAAEM, FAHA
Global Neurosciences Institute
Assistant Professor of Neurosurgery, Drexel University College of Medicine
Clinical Assistant Professor (Adjunct) of Neurology, Lewis Katz School of Medicine at Temple University
Assistant Professor of Emergency Medicine, Drexel University College of Medicine
Clinical Assistant Professor of Emergency Medicine, Philadelphia College of Osteopathic Medicine
Philadelphia, PA
Clinical Assistant Professor of Emergency Medicine, Rowan University School of Osteopathic Medicine
Stratford, NJ
Karen Greenberg, DO, DO, FACOEP-D, FAAEM, FAHA

Karen Greenberg, DO, FACOEP-D, FAAEM, FAHA is double board certified in emergency medicine and neurocritical care and highly specialized in the treatment of neurological emergencies.

Dr. Greenberg’s work was critical to the establishment of the nation’s first dedicated Neurologic Emergency Department. The American College of Osteopathic Emergency Physicians (ACOEP) recognized her innovations to speed critical treatment to patients experiencing acute ischemic stroke and awarded her its inaugural Practice Innovation Award. In 2021 Dr. Greenberg received the Willoughby Award from the ACOEP that honors the top female leader in emergency medicine.

Dr Greenberg has numerous publications in emergency, neurology, and neurosurgery journals and has authored book chapters as well. She has been honored with distinguished fellowship of the American College of Osteopathic Emergency Physicians, and is a fellow of the American Academy of Emergency Medicine and American Heart Association as well. She is an assistant professor of neurosurgery, neurology, and emergency medicine with Drexel University College of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia College of Osteopathic Medicine, and Rowan School of Osteopathic Medicine.

Statement of Need

Given the novelty of amyloid-targeting treatments (ATTs) for Alzheimer’s disease, health care professionals specializing in emergency medicine are unfamiliar with best practices for managing patients receiving ATTs who present to emergency settings with symptoms of amyloid-related imaging abnormalities (ARIA). These clinicians need to be aware of the best ARIA management guidance for supportive care, be able to interpret clinical trial protocols for management of serious ARIA events, provide tools and resources to patients, have experience with patient case examples in order to individualize treatment, and communicate with multidisciplinary colleagues about current evidence and best management practices.

The third and final episode of this CMEO BriefCase series focuses on a case involving a patient on an ATT presenting to the emergency department (ED), highlighting ED protocols to streamline care for patients with severe ARIA, recommendations for treatment and supportive care measures, global resources for guidance as the ATT landscape expands, management of ARIA according to best guidance, and communication with ATT-treating clinicians and radiologists.

Learning Objective

Manage ARIA in patients receiving ATTs according to best guidance, including communication with ATT treating clinicians and radiologists

Financial Support

This activity is supported by an educational grant from Lilly.

Target Audience

Health care providers, on a global level, who are involved in emergency medicine: Physicians, nurse practitioners (NPs), physician associates (PAs), nurses, triage specialists, and pharmacists

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Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and mitigated any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process.

Dr. Villain reports the following financial relationships:

Grants: Travel grant from GE Healthcare SAS; Merz-Pharma; and UCB Pharma GmbH

Dr. Greenberg reports the following financial relationships:

Speakers Bureau: Genentech, Inc. (ended 12/31/21)

Other financial or material support: Unpaid local principal investigator or sub-investigator for Alector, Inc.; Biogen; Eisai Inc.; Eli Lilly and Company; Janssen Global Services, LLC/Johnson & Johnson; Novo Nordisk A/S; Roche; and UCB Pharma. Unpaid national coordinator for AB Science and ADvantage Therapeutics GmbH.
Unpaid lecturer in symposia organized by Eisai Inc. and the Servier Foundation.

Disclosures were obtained from the following peer reviewer and CME Outfitters, LLC, staff, with no disclosures to report:

  • Marlon (Tony) Graham, MD (peer reviewer)
  • Elizabeth Naber, MSN, RN, CCRN-K, CNRN, TCRN (peer reviewer)
  • Susan Perry (planning committee)
  • Erin Spencer (planning committee)
  • Susan H. Yarbrough, CHCP (planning committee)
  • Sandra Caballero, PharmD (planning committee)
  • Sharon Tordoff (planning committee)

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

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How to Treat ARIA in Emergency Settings: Timely Communication with Multi-Disciplinary Colleagues
Event Date: 12/21/2023 at 5:00 am EST