Experts envision a valuable role for tau-PET in clinical practiceand drug trials

Abstract

Background: Recent advancements in Alzheimer’s disease (AD) biomarker researchand AD drug trials prompt reflection on the value and appropriate use of tau-PET infuture clinical practice and trials. We therefore conducted a survey among dementiaand PET experts worldwide to investigate how they envision the future role of tau-PETin clinical practice and trials.Method: An online survey was distributed to dementia clinicians and researchers whowere invited to participate through personalized emails, social media channels and/orpresentations at relevant conferences. With this approach we intended to recruitparticipants from different countries with diverse backgrounds and expertise. Thesurvey questions explored experts’ opinions on the value of tau-PET in clinical practiceand in drug development and trials. We used a mix of multiple choice questions,statements with a 5-point Likert scale (“strongly disagree” to “strongly agree”) and afew open questions.Result: In total 269 dementia experts, comprising 144 clinicians and 121 researchers,covering six continents completed the survey (Figure 1). The vast majority (90%)fosters a positive attitude on the added value of tau-PET in clinical practice, particularlyfor staging, diagnosing, monitoring and prognostication in a cognitively impairedmemory clinic population (Figure 2). When confronted with clinical case vignettes, ourfindings suggest that a tau-PET scan is perceived particularly useful in patients withan atypical presentation (78%) or suspicion of mixed pathology (66%) and less usefulin a typical AD case (25%). Experts are confident that a tau-PET scan could influencepatient management in current practice (median 4 “agree” [IQR 4-5]) and this wouldincrease when effective disease-modifying treatments are available (median 4 “agree”[IQR 3-4]) (Figure 2). Experts anticipate an important role for tau-PET for participantselection (76-100%) and measuring endpoints (75-97%), in both anti-amyloid andanti-tau drug trials (Figure 3).