⏱️ What is the “door-to-needle” time for amyloid-targeting treatments? 🧠 Neurologists know the mantra that "time is brain," and that amyloid-targeting treatments are more effective the earlier they are started. A new paper led by Anna Hofmann from the Washington University Memory Diagnostic Center examined this in a real-world memory clinic setting. Among 209 patients who had a single AD biomarker test (PET, CSF, or blood), the median time to starting treatment was 4.7 months. However, the 12 patients who underwent multiple biomarker tests took significantly longer: a median of 8.1 months (p = 0.002). alz-journals.onlinelibrary.w… Clinicians MUST have high confidence that patients have amyloid pathology before initiating amyloid-targeting treatments. However, performing multiple biomarker tests may delay treatment initiation. Therefore, we should consider whether multiple tests are necessary to confirm amyloid pathology. Alternatively, the biomarker testing protocol could be streamlined to enable more rapid testing. Multiple tests are certainly appropriate when diagnostic certainty is lower — for example, in atypical AD syndromes, younger patients, intermediate biomarker values, or when there is uncertainty about test performance. However, clear-cut positive biomarker results in an older patient with a typical AD syndrome are associated with an extremely high probability of amyloid pathology, and additional testing may not be indicated in these cases. nature.com/articles/s43587-0… #ENDALZ #Biomarker WashU Medicine Neurology WashU Institute for Informatics, Data Science and Biostatistics