Health system patterns of imaging and fluid biomarker testing in the era of anti‐amyloid therapies

INTRODUCTION: Anti-amyloid-β (Aβ) therapies are reshaping Alzheimer's disease (AD) management. Understanding changes in real-world patterns of diagnostic testing and infusion chair usage is essential for optimizing access to care. METHODS: Retrospective analysis of Mayo Clinic enterprise electronic health records (Jan 2019-Mar 2025) assessed trends in AD-relevant brain imaging, fluid biomarkers, apolipoprotein E (APOE) testing, and lecanemab infusions. Rates of amyloid-beta (Aβ) positivity by sex and age, APOE genotype frequencies, and lecanemab treatment initiation and discontinuation were evaluated. RESULTS: orders rapidly increased (+238/quarter). Females were more likely to be Aβ positive (p < 0.006). APOE-ε4 homozygotes were less likely to initiate lecanemab (HR = 0.11, p < 0.001). DISCUSSION: The adoption of anti-Aβ therapies coincided with a rapid shift in diagnostic workflows.

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Publication Details

Journal
Alzheimer s & Dementia
Published
2026-04-01
DOI
https://doi.org/10.1002/alz.71343
Primary Topic
Dementia and Cognitive Impairment Research
Type
article
Field-Weighted Citation Impact
0.00

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article

Health system patterns of imaging and fluid biomarker testing in the era of anti‐amyloid therapies

Felipe Derteano Martínez, V E Ortega, Christopher Grilli, W Hudson Robb et al.
Alzheimer s & Dementia
Dementia and Cognitive Impairment Research
article

Health system patterns of imaging and fluid biomarker testing in the era of anti‐amyloid therapies

Felipe Derteano Martínez, V E Ortega, Christopher Grilli, W Hudson Robb, Richard Keegan, Ephraim E. Parent, Ming Yang, Clifford Shin, Steven K. Huang, Gurkiran Kaur, Ba Thang Nguyen, Mary Ellen Koran, Vijay K. Ramanan, David P. Upjohn, Petrice M. Cogswell, Christopher T. Conyers, Jonathan Graff‐Radford, Timothy J. Hohman, Derek R. Johnson
article en

Abstract

INTRODUCTION: Anti-amyloid-β (Aβ) therapies are reshaping Alzheimer's disease (AD) management. Understanding changes in real-world patterns of diagnostic testing and infusion chair usage is essential for optimizing access to care. METHODS: Retrospective analysis of Mayo Clinic enterprise electronic health records (Jan 2019-Mar 2025) assessed trends in AD-relevant brain imaging, fluid biomarkers, apolipoprotein E (APOE) testing, and lecanemab infusions. Rates of amyloid-beta (Aβ) positivity by sex and age, APOE genotype frequencies, and lecanemab treatment initiation and discontinuation were evaluated. RESULTS: orders rapidly increased (+238/quarter). Females were more likely to be Aβ positive (p < 0.006). APOE-ε4 homozygotes were less likely to initiate lecanemab (HR = 0.11, p < 0.001). DISCUSSION: The adoption of anti-Aβ therapies coincided with a rapid shift in diagnostic workflows.

Alzheimer s & DementiaVol. 22(4)
Mayo Clinic (US), Vanderbilt University (US), Jacksonville College (US), Mayo Clinic in Arizona (US), Mayo Clinic in Florida (US), ABT Molecular Imaging (United States) (US), Vanderbilt University Medical Center (US)
Alzheimer's Association, National Institute on Aging
Openalex Percentile: Top 20%
Dementia and Cognitive Impairment Research
DOIOpen Access PDFOpenAlex
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