Real-world evidence on lecanemab points to measurable ARIA risk, according to a meta-analysis of 37 studies. Across routine use, ARIA occurred in 15.1% of cases, with higher rates in APOE ε4 homozygotes and people with baseline microhemorrhages. The analysis also concluded that evidence remains insufficient to confirm cognitive efficacy outside controlled trial settings. For developers and clinicians, the key operational detail is that the safety profile is translating into broader practice with identifiable subgroups at elevated risk. That can influence patient selection, monitoring protocols, and real-world benefit-risk discussions. The findings also reinforce how post-approval evidence continues to shape label interpretation and ongoing data collection requirements for Alzheimer’s disease agents.