Optimizing Amyloid Biomarker Use to Guide Antiamyloid Immunotherapy Eligibility in Alzheimer Disease: Suzanne Schindler, MD, PhD

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"The main takeaway is that by integrating clinical assessment and biomarker tests, you’re able to diagnose patients with high certainty with amyloid pathology, typically with a single test. Then you can talk to the patient and decide whether, from other standpoints, they’re candidates for these treatments. "

The use of amyloid biomarkers to guide eligibility for antiamyloid immunotherapies is rapidly reshaping the diagnostic and treatment landscape in Alzheimer disease (AD). As disease-modifying therapies targeting amyloid pathology become increasingly integrated into clinical practice, clinicians must accurately identify which patients have underlying amyloid deposition as the cause of their cognitive symptoms. In this context, the role of biomarkers, including amyloid positron emission tomography (PET), cerebrospinal fluid (CSF) assays, and emerging blood-based tests, has become central to achieving diagnostic certainty and appropriately selecting candidates for therapy.

At the 2026 Alzheimer’s Association International Conference (AAIC), held July 12-15, in London, United Kingdom, Suzanne Schindler, MD, PhD, professor of neurology at Washington University in St. Louis, presented a plenary session titled, “Eligibility for Anti-Amyloid Immunotherapy: Amyloid Biomarkers in the Real World.” In her presentation, she discussed how clinicians can integrate clinical assessment with biomarker testing to determine whether a patient’s symptoms are attributable to AD and to assess eligibility for antiamyloid immunotherapies. In addition, Schindler reviewed the current use of amyloid PET, CSF measures, and blood-based biomarkers in practice and highlighted the evolving role of blood tests as they become more widely adopted by providers.

In a follow-up interview with NeurologyLive^®, Schindler elaborated on the key messages from her plenary talk, focusing on the importance of combining clinical evaluation with biomarker data to diagnose amyloid pathology. She emphasized the growing utility of blood-based biomarkers, particularly plasma p-tau 217, noting its superiority over other commonly ordered assays such as plasma Aβ42/40 or p-tau 181 for indicating amyloid pathology. Furthermore, Schindler discussed the need for more data in diverse and comorbid patient populations, the anticipated future shift toward using blood tests as the initial diagnostic modality, and the current gap between available diagnostic tools and the relatively small number of patients who are accurately diagnosed.

Click here for more coverage of AAIC 2026.

REFERENCES
1. Schindler SE. Eligibility for Anti-Amyloid Immunotherapy: Amyloid Biomarkers in the Real World. Presented at: 2026 Alzheimer’s Association International Conference; July 12-15; London, United Kingdom. Plenary Session.