Plasma p-tau217 acts as a high-sensitivity ‘Core 1’ biomarker for identifying amyloid-β (Aβ) pathology, whereas eMTBR-tau243 serves as a ‘Core 2’ biomarker reflecting tau tangle burden and clinical symptom onset.
Integrating eMTBR-tau243 in p-tau217-positive patients increases the positive predictive value (PPV) for established Alzheimer’s disease (AD) from 57% to 84%, significantly reducing diagnostic uncertainty.
Plasma eMTBR-tau243 concentrations correlate strongly with tau-PET load and are predictive of longitudinal cognitive decline and future tau accumulation.
The implementation of sequential blood-based biomarker (BBM) algorithms could reduce the requirement for expensive PET imaging by 58%–80% in clinical trial and specialist settings.
