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CTAD 2025 | The biological staging of AD using blood-based biomarkers: combining p-tau217 and MTBR-tau243

Gemma Salvadó, MSc, PhD, Barcelonaβeta Brain Research Center (BBRC), Barcelona, Spain, discusses the biological staging of Alzheimer’s disease (AD) using blood-based biomarkers. Dr Salvadó notes that combining p-tau217 and MTBR-tau243 could be used to classify patients depending on the stage of their biological pathology. This interview took place at the 18th Clinical Trials on Alzheimer’s Disease (CTAD) Conference in San Diego, CA.

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Transcript

So the idea behind this presentation is that of course we have now some clinical suggestions on how to stratify Alzheimer’s disease patients and how this can help us with the clinical management to select optimal patients for specific treatments. So currently, this has been suggested to be done via amyloid and tau PET. However, of course, this is not manageable for a large number of participants, and it’s only doable in very specific centers...

So the idea behind this presentation is that of course we have now some clinical suggestions on how to stratify Alzheimer’s disease patients and how this can help us with the clinical management to select optimal patients for specific treatments. So currently, this has been suggested to be done via amyloid and tau PET. However, of course, this is not manageable for a large number of participants, and it’s only doable in very specific centers. So the idea behind it is to try to do a similar classification, but now using plasma biomarkers instead, which can be done more widely. And of course, they are easy to assess, less invasive and cheaper. So the idea is that we have a very accurate plasma biomarker related to mainly amyloid pathology, that is P-Tau217. And we recently validated another biomarker called MTBR-tau243 that seems to be more related to tau pathology as it is measured by tau PET. Therefore, we aim to use these two plasma biomarkers combined to perform a classification of participants depending on the stage of their biological pathology in their brains. So what we found is that indeed we could stratify patients of Alzheimer’s disease using these two biomarkers. The classification was highly accurate compared to the one done by amyloid and tau PET. And we also could clearly see a correlation between these stratification and clinical outcomes compared to MMSE or a preclinical cognitive composite, for instance. And finally, we also observed that we also could predict somehow who was more likely to progress in the clinical status using this plasma staging. And finally, we validated it in an independent cohort using even neuropathological data. So having like the gold standard of Alzheimer’s disease pathology.

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Disclosures

GS has received speaker or advisory fees from Springer, GE Healthcare, Biogen, Esteve, Adium and Johnson&Johnson.