Blood-based biomarkers in Alzheimer's disease: Future directions for implementation

Ivonne Suridjan, Wiesje M. van der Flier, Andreas U. Monsch, Nerida Burnie, Robert Baldor, Marwan Sabbagh, Josep Vilaseca, Dongming Cai, Margherita Carboni, James J. Lah

Research output: Contribution to journalArticlepeer-review

Abstract

INTRODUCTION: Disease-modifying therapies (DMTs) for Alzheimer's disease (AD) will increase diagnostic demand. A non-invasive blood-based biomarker (BBBM) test for detection of amyloid-β pathology may reduce diagnostic barriers and facilitate DMT initiation. OBJECTIVE: To explore heterogeneity in AD care pathways and potential role of BBBM tests. METHODS: Survey of 213 healthcare professionals/payers in US/China/UK/Germany/Spain/France and two advisory boards (US/Europe). RESULTS: Current diagnostic pathways are heterogeneous, meaning many AD patients are missed while low-risk patients undergo unnecessary procedures. Confirmatory amyloid testing (cerebrospinal fluid biomarkers/positron emission tomography) is utilized in few patients, resulting in diagnostic/treatment delays. A high negative-predictive-value test could streamline the diagnostic pathway by reducing unnecessary procedures in low-risk patients; supporting confirmatory testing where needed. Imminent approval of DMTs will increase need for fast and reliable AD diagnostic tests. DISCUSSION: An easy-to-use, accurate, non-invasive BBBM test for amyloid pathology could guide diagnostic procedures or referral, streamlining early diagnosis and DMT initiation. Highlights: This study explored AD care pathways and how BBBM may meet diagnostic demands Current diagnostic pathways are heterogeneous, with country and setting variations Many AD patients are missed, while low-risk patients undergo unnecessary procedures An easy-to-use, accurate, non-invasive BBBM test for amyloid pathology is needed This test could streamline early diagnosis of amyloid pathology and DMT initiation.

Original languageEnglish (US)
Article numbere12508
JournalAlzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Volume15
Issue number4
DOIs
StatePublished - Oct 1 2023

Bibliographical note

Publisher Copyright:
© 2023 Roche Diagnostics International Ltd and The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals LLC on behalf of Alzheimer's Association.

Keywords

  • Alzheimer's disease
  • amyloid pathology
  • blood-based biomarker
  • clinical practice
  • diagnosis
  • qualitative
  • screening

PubMed: MeSH publication types

  • Journal Article

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