Plasma amyloid-β42/40 and apolipoprotein E for amyloid PET pre-screening in secondary prevention trials of Alzheimer's disease.

Autor:	Cullen NC; Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, 202 13 Lund, Sweden., Janelidze S; Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, 202 13 Lund, Sweden., Stomrud E; Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, 202 13 Lund, Sweden.; Memory Clinic, Skåne University Hospital, 205 02 Malmö, Sweden., Bateman RJ; Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA., Palmqvist S; Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, 202 13 Lund, Sweden.; Memory Clinic, Skåne University Hospital, 205 02 Malmö, Sweden., Hansson O; Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, 202 13 Lund, Sweden.; Memory Clinic, Skåne University Hospital, 205 02 Malmö, Sweden., Mattsson-Carlgren N; Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, 202 13 Lund, Sweden.; Department of Neurology, Skåne University Hospital, 221 85 Lund, Sweden.; Wallenberg Center for Molecular Medicine, Lund University, 221 84 Lund, Sweden.
Jazyk:	angličtina
Zdroj:	Brain communications [Brain Commun] 2023 Jan 24; Vol. 5 (2), pp. fcad015. Date of Electronic Publication: 2023 Jan 24 (Print Publication: 2023).
DOI:	10.1093/braincomms/fcad015
Abstrakt:	The extent to which newly developed blood-based biomarkers could reduce screening costs in secondary prevention trials of Alzheimer's disease is mostly unexplored. We collected plasma amyloid-β42/40, apolipoprotein E ε4 status and amyloid PET at baseline in 181 cognitively unimpaired participants [the age of 72.9 (5.3) years; 61.9% female; education of 11.9 (3.4) years] from the Swedish BioFINDER-1 study. We tested whether a model predicting amyloid PET status from plasma amyloid-β42/40, apolipoprotein E status and age (combined) reduced cost of recruiting amyloid PET + cognitively unimpaired participants into a theoretical trial. We found that the percentage of cognitively unimpaired participants with an amyloid PET + scan rose from 29% in an unscreened population to 64% [(49, 79); P < 0.0001] when using the biomarker model to screen for high risk for amyloid PET + status. In simulations, plasma screening also resulted in a 54% reduction of the total number of amyloid PET scans required and reduced total recruitment costs by 43% [(31, 56), P < 0.001] compared to no pre-screening when assuming a 16× PET-to-plasma cost ratio. Total savings remained significant when the PET-to-plasma cost ratio was assumed to be 8× or 4×. This suggests that a simple plasma biomarker model could lower recruitment costs in Alzheimer's trials requiring amyloid PET positivity for inclusion. (© The Author(s) 2023. Published by Oxford University Press on behalf of the Guarantors of Brain.)
Databáze:	MEDLINE
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