Original Investigation

Plasma eMTBR-tau243 and %p-tau217 for Biological Staging of Alzheimer Disease

JAMA Neurology 10.1001/jamaneurol.2026.1405

May 26, 2026 at 11:00 AM EDT

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Can plasma %p-tau217 and eMTBR-tau243 be combined to approximate an amyloid and tau positron emission tomography (PET)–based Alzheimer disease biological staging scheme?In 872 BioFINDER-2 participants and 156 independent Knight Alzheimer Disease Research Center participants, a plasma model combining %p-tau217 and eMTBR-tau243 showed strong concordance with PET-based biological staging and outperformed a %p-tau217–only model, particularly for identifying the intermediate tau stage. Advanced plasma stages also aligned with greater clinical severity, other biomarker abnormalities, and neuropathologic burden.Plasma-based staging may provide a scalable, minimally invasive approach to biological stratification of Alzheimer disease, with potential value for treatment selection and clinical trial enrichment.

Corresponding Authors: Gemma Salvadó, PhD (gemma.salvado@med.lu.se), and Oskar Hansson, MD, PhD (oskar.hansson@med.lu.se), Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, S:t Johannesgatan 8, 211 46 Malmö, Sweden.

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