Interesting approach to trying to avoid ARIA issues faced by #leqembi and #donanemab, at least hypothetically. I'm curious about a few things though:
1. Will there be reimbursement challenges given the potential high price of gene therapies?
2. Would this be a second-line therapy after patients encounter ARIA with anti-amyloid mAb or specifically indicated for APOE4 carriers or E4/E4 patients, given their increased risk for ARIA?
3. A more provocative idea - assuming it's very durable, would it make sense to treat E4/E4 patients before they have symptoms? If it's gonna be one shot and E4/E4 patients will develop symptoms sooner or later, would you rather keep patients in a cognitive normal state or a mildly cognitive impaired state longer?
Would love to hear different opinions from my network!
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