Beyond Amyloid: New Alzheimer’s Drug Targets Tau Protein and Offers Hope for Future Treatments

For decades, Alzheimer’s research has focused heavily on one protein: amyloid. Newer medications such as lecanemab (Leqembi) and donanemab (Kisunla) have shown that removing amyloid plaques from the brain can modestly slow cognitive decline in some people with early Alzheimer’s disease.

Now researchers are exploring another approach: targeting tau, a different brain protein closely linked to memory loss and disease progression. A new experimental medication called diranersen has shown early promise by reducing tau production and slowing cognitive decline in people with mild cognitive impairment or early Alzheimer’s disease. While more research is needed, this represents an important shift in the search for better Alzheimer’s treatments.

Understanding Alzheimer’s Disease: The Amyloid-Tau Connection

Alzheimer’s disease is a complex condition involving changes inside brain cells. Two proteins are believed to play major roles.

Amyloid protein forms plaques between brain cells, begins accumulating years before symptoms appear, and is the target of current Alzheimer’s medications.

Tau protein normally helps maintain the structure of brain cells. In Alzheimer’s disease, abnormal tau forms tangles inside neurons. These tangles interfere with communication between brain cells and are strongly associated with cognitive decline.

Researchers believe amyloid may trigger a chain reaction that eventually leads to abnormal tau accumulation.

How Does Diranersen Work?

Diranersen belongs to a class of medications called antisense oligonucleotides. Instead of trying to remove existing tau buildup, the medication works by targeting the gene responsible for producing tau, reducing the amount of tau made by brain cells, and allowing the brain’s natural cleanup systems to better remove abnormal proteins.

Unlike traditional medications delivered through the bloodstream, diranersen is injected into the fluid surrounding the spinal cord, providing a more direct pathway toward the brain.

What Did the Study Find?

The clinical trial included approximately 400 participants with mild cognitive impairment due to Alzheimer’s disease or mild Alzheimer’s disease. Researchers found lower tau levels in the brain, slower worsening of memory and thinking abilities, and encouraging results with a twice-yearly injection schedule.

One analysis suggested the lowest dose reduced cognitive decline by approximately 26%, a result researchers said was similar to improvements seen in earlier amyloid-targeting treatments. However, researchers emphasize that this was an early-stage study, and larger trials are needed before the medication could become an approved treatment.

How Does This Compare With Current Alzheimer’s Treatments?

Current approved Alzheimer’s medications, including lecanemab and donanemab, focus mainly on amyloid removal. These medications may slow disease progression but do not reverse Alzheimer’s disease.

Tau-targeting therapies could potentially provide another tool by addressing a different biological pathway. Future treatment approaches may combine amyloid-targeting medications, tau-targeting therapies, lifestyle interventions, and earlier diagnosis through biomarkers.

What Are Other Alzheimer’s Research Directions?

Scientists are investigating several promising approaches, including tau vaccines designed to train the immune system to recognize harmful tau proteins, research into whether cholesterol-related medications may influence Alzheimer’s risk (especially in people carrying the APOE4 genetic variant), and new technologies aimed at helping medicines cross the blood-brain barrier more effectively.

What Can Patients Do Today to Support Brain Health?

While there is no guaranteed way to prevent Alzheimer’s disease, evidence supports several healthy aging strategies:

• Maintain cardiovascular health. Heart health and brain health are closely connected — control blood pressure, manage cholesterol, and maintain healthy blood sugar levels.
• Stay physically active. Regular exercise supports circulation and brain function.
• Stay socially and mentally engaged. Learning, hobbies, and social connections may support cognitive resilience.
• Review medications regularly. Some medications may affect cognition, especially in older adults. A pharmacist can help identify potential concerns.

Centrum Pharmacy: Supporting Healthy Aging

At Centrum Pharmacy, our pharmacists support patients through every stage of life with medication reviews, chronic disease management, blood pressure monitoring, vaccinations, personalized health consultations, and collaboration with healthcare providers.

As research continues to advance, our goal remains the same: helping our Orleans community make informed decisions about their health. Your brain health matters. Your overall health matters. Your Centrum Pharmacy team is here to support you.

Disclaimer: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your healthcare provider first. Full Disclaimer.