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AAIC 2022 | Head-to-head comparison of p-tau species for Alzheimer’s disease detection in a real-world cohort

Phosphorylated tau (p-tau) is a valuable marker of Alzheimer’s disease (AD) and several species of p-tau in the blood have been shown to detect AD pathology with high accuracy. Marc Suárez-Calvet, MD, PhD, Barcelonaβeta Brain Research Center (BBRC), Barcelona, Spain, shares the details of a head-to-head comparison of nine p-tau assays to determine their ability to distinguish AD from non-AD (based on cerebrospinal fluid Aβ42/p-tau181). Almost 200 patients from a real-world memory clinic were studied and all p-tau markers were found to be higher in the AD group compared to the non-AD group. All p-tau markers were able to significantly discriminate between AD and non-AD. The largest effect sizes were found in plasma Janssen P-tau217 (r = 0.76), Lilly P-tau217 (r = 0.73), ADx P-tau181 (r = 0.73), Lilly P-tau181 (r = 0.68), and UGot P-tau231 (r = 0.63). This interview took place at the Alzheimer’s Association International Conference (AAIC) 2022 in San Diego, CA.

Transcript (edited for clarity)

I think that one of the most important findings in the last years in the Alzheimer’s disease field has been the development of several blood biomarkers to detect Alzheimer’s disease. And I think that in particular, the phospho-tau biomarkers are one of those that are more promising.

However, I think that there are two issues that need still to be addressed regarding blood phospho-tau biomarkers...

I think that one of the most important findings in the last years in the Alzheimer’s disease field has been the development of several blood biomarkers to detect Alzheimer’s disease. And I think that in particular, the phospho-tau biomarkers are one of those that are more promising.

However, I think that there are two issues that need still to be addressed regarding blood phospho-tau biomarkers. First of all is that most of the studies have been performing in research cohorts. So we need more data, more information in the real world, so in general hospitals, in primary care, in order to see whether these great results that we see in research cohorts also work so well in the general population, in public hospitals. So in a more diverse population in the real world.

And the other issue is that now we have several blood phospho-tau biomarkers that seem to work very, very, very well. But what we need also is to do kind of a head to head comparison of all this blood phospho-tau biomarkers in order to see, in order to assess whether that some of them perform better than the others.

And actually, this is what we are doing in this study that we are presenting at AAIC in San Diego this year. What we did is to measure nine plasma phospho-tau biomarkers and nine CSF ones. And we did it in the patients of Hospital del Mar, which is a public hospital in Barcelona, and what we see is that many of these phospho-tau blood biomarkers, they are really good. They have a high accuracy in order to detect Alzheimer disease pathology and some of them actually, they perform in a similar way as the CSF. So I think that we have very good news.

So our data supports the idea that at least some of these blood phospho-tau biomarkers seem to work very well not only in research cohorts, but also in the real world, in a memory clinic in the hospital. And now what we have to this try to work in order to implement this blood phospho-tau biomarkers in the clinical routine.

I think that we have the example of the CSF biomarkers, that it took a long time to implement them in the hospitals and still in many hospitals around the world they do not use routinely CSF biomarkers. It cannot take so long for blood biomarkers.

We have excellent blood biomarkers, in particular the phospho-tau, and now we have to work in order to implement them to see if they work well in different populations all around the world, if they are influenced by different morbidities. We have to test them in diverse populations, but we really need to work to implement these blood phospho-tau biomarkers.

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