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We tested the utility of plasma GFAP for population enrichment CU populations in clinical trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We estimated longitudinal progression, effect size, and costs of hypothetical clinical trials designed to test an estimated 25% drug effect on reducing tau positron emission tomography (PET) accumulation in the medial temporal lobe (MTL) and temporal neocortical region (NEO\u2010T).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      CU GFAP+\/A\u03b2+ individuals present an increased annual rate of change and effect size in tau PET\n                      <jats:sub>MTL<\/jats:sub>\n                      and tau PET\n                      <jats:sub>NEO\u2010T<\/jats:sub>\n                      compared to the other groups. An enrichment strategy selecting CU GFAP+\/A\u03b2+ individuals would require a smaller sample size (\u2248 57% reduction) and fewer A\u03b2 PET scans (\u2248 74% reduction) than trials enriched with A\u03b2 PET alone, reducing total clinical trial costs by up to 64%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Our results suggest that clinical trials focusing on preclinical AD recruiting A\u03b2+ individuals with elevated GFAP levels would improve cost effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Cognitively unimpaired (CU) glial fibrillary acidic protein (GFAP)+\/amyloid beta (A\u03b2)+ shows increased changes in tau positron emission tomography (PET) .<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>CU GFAP+\/A\u03b2+ enriched clinical trials require a reduced sample size compared to A\u03b2+ only.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>CU GFAP+\/A\u03b2+ enrichment reduces A\u03b2 PET scans required and costs.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>CU GFAP+\/A\u03b2+ enrichment allows the selection of individuals at early stages of the Alzheimer's disease continuum.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70209","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T23:24:26Z","timestamp":1746833066000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Plasma GFAP for populational enrichment of clinical trials in preclinical Alzheimer's disease"],"prefix":"10.1002","volume":"21","author":[{"given":"Bruna","family":"Bellaver","sequence":"first","affiliation":[{"name":"Department of Psychiatry University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme","family":"Povala","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela C. 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de sant\u00e9 et de services sociaux (CIUSSS) de l'Ouest\u2010de\u2010l'\u00cele\u2010de\u2010Montr\u00e9al  Montreal Quebec Canada"},{"name":"Department of Neurology and Neurosurgery Psychiatry and Pharmacology and Therapeutics McGill University  Montreal Quebec Canada"},{"name":"Lawrence Berkeley National Laboratory  Berkeley California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Therriault","sequence":"additional","affiliation":[{"name":"Translational Neuroimaging Laboratory McGill University Research Centre for Studies in Aging Alzheimer's Disease Research Unit Douglas Research Institute Le Centre int\u00e9gr\u00e9 universitaire de sant\u00e9 et de services sociaux (CIUSSS) de l'Ouest\u2010de\u2010l'\u00cele\u2010de\u2010Montr\u00e9al  Montreal Quebec Canada"},{"name":"Department of Neurology and Neurosurgery Psychiatry and Pharmacology and Therapeutics McGill University  Montreal Quebec 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