C2N Diagnostics, St. Louis, Missouri, USA.
Biogen, Cambridge, Massachusetts, USA.
Ann Clin Transl Neurol. 2023 May;10(5):765-778. doi: 10.1002/acn3.51763. Epub 2023 Mar 28.
The amyloid probability score (APS) is the model read-out of the analytically validated mass spectrometry-based PrecivityAD blood test that incorporates the plasma Aβ42/40 ratio, ApoE proteotype, and age to identify the likelihood of brain amyloid plaques among cognitively impaired individuals being evaluated for Alzheimer's disease.
This study aimed to provide additional independent evidence that the pre-established APS algorithm, along with its cutoff values, discriminates between amyloid positive and negative individuals.
The diagnostic performance of the PrecivityAD test was analyzed in a cohort of 200 nonrandomly selected Australian Imaging, Biomarker & Lifestyle Flagship Study of Aging (AIBL) study participants, who were either cognitively impaired or healthy controls, and for whom a blood sample and amyloid PET imaging were available.
In a subset of the dataset aligned with the Intended Use population (patients aged 60 and older with CDR ≥0.5), the pre-established APS algorithm predicted amyloid PET with a sensitivity of 84.9% (CI: 72.9-92.1%) and specificity of 96% (CI: 80.5-99.3%), exclusive of 13 individuals for whom the test was inconclusive.
The study shows individuals with a high APS are more likely than those with a low APS to have abnormal amounts of amyloid plaques and be on an amyloid accumulation trajectory, a dynamic and evolving process characteristic of progressive AD pathology. Exploratory data suggest APS retains its diagnostic performance in healthy individuals, supporting further screening studies in the cognitively unimpaired.
淀粉样蛋白概率评分(APS)是分析验证的基于质谱的 PrecivityAD 血液检测的模型输出,该检测结合了血浆 Aβ42/40 比值、ApoE 表型和年龄,以识别认知障碍个体中脑淀粉样斑块的可能性,这些个体正在接受阿尔茨海默病的评估。
本研究旨在提供额外的独立证据,证明预先建立的 APS 算法及其截止值可区分淀粉样蛋白阳性和阴性个体。
在 200 名非随机选择的澳大利亚成像、生物标志物和生活方式老化旗舰研究(AIBL)研究参与者的队列中分析了 PrecivityAD 检测的诊断性能,这些参与者要么认知障碍,要么是健康对照者,并且有血液样本和淀粉样蛋白 PET 成像。
在与预期用途人群(年龄在 60 岁及以上、CDR≥0.5 的患者)相符的数据集子集中,预先建立的 APS 算法预测淀粉样蛋白 PET 的敏感性为 84.9%(CI:72.9-92.1%),特异性为 96%(CI:80.5-99.3%),排除了 13 名测试结果不确定的个体。
该研究表明,APS 较高的个体比 APS 较低的个体更有可能有异常数量的淀粉样斑块,并处于淀粉样蛋白积累轨迹上,这是一种与进行性 AD 病理相关的动态和演变过程。探索性数据表明 APS 在健康个体中保留了其诊断性能,支持在认知无障碍个体中进行进一步的筛查研究。