TY - JOUR
T1 - Blood-based biomarkers in Alzheimer's disease
T2 - Future directions for implementation
AU - Suridjan, Ivonne
AU - van der Flier, Wiesje M.
AU - Monsch, Andreas U.
AU - Burnie, Nerida
AU - Baldor, Robert
AU - Sabbagh, Marwan
AU - Vilaseca, Josep
AU - Cai, Dongming
AU - Carboni, Margherita
AU - Lah, James J.
N1 - Funding Information: This work was supported by Roche Diagnostics International Ltd (Rotkreuz, Switzerland), who initiated and sponsored the advisory board meetings where discussions on this topic were held. 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.
PY - 2023/10/1
Y1 - 2023/10/1
N2 - 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.
AB - 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.
KW - Alzheimer's disease
KW - amyloid pathology
KW - blood-based biomarker
KW - clinical practice
KW - diagnosis
KW - qualitative
KW - screening
UR - http://www.scopus.com/inward/record.url?scp=85178931377&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/dad2.12508
DO - https://doi.org/10.1002/dad2.12508
M3 - Article
C2 - 38058357
SN - 2352-8729
VL - 15
JO - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
JF - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
IS - 4
M1 - e12508
ER -