Plasma amyloid-β42/40 and apolipoprotein E for amyloid PET pre-screening in secondary prevention trials of Alzheimer’s disease
Year: 2023
Type: article
Abstract: 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.
Source: Brain Communications
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,443
Funders: Australian Government, European Commission, Lunds Universitet, Knut och Alice Wallenbergs Stiftelse, Vetenskapsrådet, Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse, Skånes universitetssjukhus, Marcus och Amalia Wallenbergs minnesfond, Stiftelsen Bundy Academy, Parkinsonfonden, H2020 European Research Council
Awards: The Alzheimer biomarker toolbox – use in pathogenic studies, diagnostics and theragnostics, Development of new biomarkers and brain imaging techniques for Dementia and Parkinsonian disorders: key tools for exploring etiology to improve diagnosis and advance drug development, G3480186095, G4028979961, G5166548482, G5184609404, G6066643948, Multi-omics Interdisciplinary Research Integration to Address DEmentia diagnosis, Pathways to Alzheimer's disease, G712881263, Development of biomarkers in Alzheimer’s disease: improvement of early and accurate diagnosis and increased understanding of disease mechanisms that facilitates drug development, A precision medicine approach for the diagnosis and prognosis of preclinical Alzheimer´s disease with implications for clinical trials, 3rd International Conference on Tomography of Materials and Structures
OpenAlex ID: W4318034384