- Meyer, Matthew;
- Kirmess, Kristopher;
- Eastwood, Stephanie;
- Wente-Roth, Traci;
- Irvin, Faith;
- Holubasch, Mary;
- Venkatesh, Venky;
- Fogelman, Ilana;
- Monane, Mark;
- Hanna, Lucy;
- Rabinovici, Gil;
- Siegel, Barry;
- Whitmer, Rachel;
- Apgar, Charles;
- Bateman, Randall;
- Holtzman, David;
- Irizarry, Michael;
- Verbel, David;
- Sachdev, Pallavi;
- Ito, Satoshi;
- Contois, John;
- Yarasheski, Kevin;
- Braunstein, Joel;
- Verghese, Philip;
- West, Tim
BACKGROUND: With the availability of disease-modifying therapies for Alzheimers disease (AD), it is important for clinicians to have tests to aid in AD diagnosis, especially when the presence of amyloid pathology is a criterion for receiving treatment. METHODS: High-throughput, mass spectrometry-based assays were used to measure %p-tau217 and amyloid beta (Aβ)42/40 ratio in blood samples from 583 individuals with suspected AD (53% positron emission tomography [PET] positive by Centiloid > 25). An algorithm (PrecivityAD2 test) was developed using these plasma biomarkers to identify brain amyloidosis by PET. RESULTS: The area under the receiver operating characteristic curve (AUC-ROC) for %p-tau217 (0.94) was statistically significantly higher than that for p-tau217 concentration (0.91). The AUC-ROC for the PrecivityAD2 test output, the Amyloid Probability Score 2, was 0.94, yielding 88% agreement with amyloid PET. Diagnostic performance of the APS2 was similar by ethnicity, sex, age, and apoE4 status. DISCUSSION: The PrecivityAD2 blood test showed strong clinical validity, with excellent agreement with brain amyloidosis by PET.