Optimizing Lumipulse plasma pTau217/Aβ42 ratio cutpoints in an Asian cohort with high cerebrovascular disease burden

In 205 Singapore participants, the Lumipulse plasma pTau217/Aβ42 ratio distinguished amyloid status better than pTau217 alone (AUC 0.951 vs 0.925; p=0.004), with similar performance across CeVD severities.

• Why it matters: FDA-cleared Lumipulse cutpoints may not generalize to Asian populations, particularly where concomitant cerebrovascular disease burden is high, risking misclassification of brain amyloid pathology.
• What they did: The study measured plasma pTau217, Aβ42, and their ratio and derived in-house three-range cutpoints targeting 95% sensitivity and specificity using amyloid neuroimaging in 205 Singapore-based participants.
• The result: In-house cutpoints produced 98% negative predictive value, 88% positive predictive value, 95% accuracy, and labeled 10% intermediate-risk; FDA-cleared cutpoints kept 97% sensitivity and NPV but reduced specificity to 86%, PPV to 77%, accuracy to 85%, and increased intermediate-risk to 29%.

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