Aggregated Tau and the associated risk of clinical progressi
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Clinically applicable visual reads of flortaucipir PET scans may provide valuable information regarding the risk of near-term clinical deterioration among patients with clinically diagnosed mild cognitive impairment or dementia owing to AD.

The study objective was to evaluate the association between flortaucipir PET visual interpretation and patients’ near-term clinical progression.

Two prospective, open-label, longitudinal studies were conducted. Study 1 screened 298 patients and enrolled 160 participants who had a flortaucipir scan at baseline visit. Study 2 selected 205 participants from the AMARANTH trial, which was terminated after futility analysis. Out of the 2218 AMARANTH participants, 424 had a flortaucipir scan around randomization, but 219 did not complete 18-month clinical dementia rating (CDR) assessments and thus were excluded. In both studies, all participants were diagnosed as clinically impaired, and they were longitudinally followed up for approximately 18 months after baseline.

--240 participants were rated as having an advanced AD pattern. At 18 months follow-up, 70% of those with an advanced AD pattern had a 1 point or more increase in CDR-SB, an event predefined as clinically meaningful deterioration.

--In contrast, only 46% of those with a nonadvanced AD pattern scan experienced the same event.

--The adjusted mean CDR-SB changes were 2.28 and 0.98 for advanced and nonadvanced AD pattern groups, respectively.

--Analyses with other clinical endpoint assessments, as well as analyses with each individual study’s data, consistently indicated a higher risk of clinical deterioration associated with an advanced AD scan pattern.

These results suggest that flortaucipir PET scans, when interpreted with a US Food and Drug Administration–approved, clinically applicable visual interpretation method, may provide valuable information regarding the risk of clinical deterioration over 18 months among patients with AD and MCI.

JAMA Neurology
Source: https://jamanetwork.com/journals/jamaneurology/fullarticle/2775982
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