Table 2 Tau therapeutics in clinical trials
From: The informed road map to prevention of Alzheimer Disease: A call to arms
Class | Compound | Current status | Disease Stage | Trial # | Sample Size | Preclinical models used | Trial Outcome measures | Opportunity for preventiona | Evidence from clinical studies |
|---|---|---|---|---|---|---|---|---|---|
Immuno-therapies (active vaccine and passive antibodies) | AADvac1—active vaccine against truncated N-terminal tau | Phase 2 (mild AD) | Mild AD | NCT02579252 | 208 | Human truncated tau cDNA-rat | Safety; | Yes | Slowing of NfL rise; possible slowing of MRI atrophy and CSF p-tau |
ABBV-8E12—passive; N-terminal of aggregated tau | Phase 2 | Mild AD PSP | NCT02880956 | 453 | P301S | AD-ongoing PSP-clinical progression | Possible | Phase 2 study in PSP demonstrated no clinical/imaging benefit at interim | |
BIIB076—passive; N-terminal mid-domain tau | Phase 1 | AD | NCT03056729 | 46 | P301L | Safety | Possible | Phase 1 completed-results pending | |
Gosuranemab—passive; N-terminal extracellular tau | Phase 2 | AD PSP | NCT03352557 | 654 | ADAD iPSC; P301L | Safety; | Yes | Phase 2 study in PSP demonstrated no clinical | |
JNJ-63733657—passive; mid-domain (tau seeds) | Phase 1 | Mild AD | NCT03375697 | 72 | P301L | Safety | possible | Safety study in mild AD completed; results pending | |
Semorinemab—passive; n-terminal (monomeric/oligomeric) | Phase 2 | Mild AD | NCT03828747 NCT03289143 | 260b 457 | P301L | Clinical/Cognition | possible | Phase 2 study reported no effect on cognitive decline | |
Microtubule stabilizer | epothilone D—microtubule stabilizer (taxane derivative) [70] | Discontinued | Mild AD | NCT01492374 | 40 | P301L P301S | Safety/CSF biomarkers | Unknown | Phase 1b study completed but no results provided |
TPI287-tubulin-binding and microtubule-stabilizing (taxane derivative) | Phase 1 | AD PSP CBS | NCT01966666 | 29 | NA | Saftey/CSF PK | Unknown | Lack of clear clinical benefit for all tauopathies tested; increased anaphylactoid reaction in AD [71] | |
Tau Aggregation inhibitor | Anle138b—general inhibitor of protein aggregation [72] | Phase 1 | Healthy adults | NCT04208152 | 68 | P301S [73] hTau [72] | Safety | Possible | Good safety in phase 1 healthy adults |
LMTM-second-generation tau protein aggregation inhibitor (Aminothienopyridazines) [74] | Phase 3 | AD FTD | NCT03446001 | 588†| Recombinant Tau/cellular models | Clinical/cognitive decline | Possible | Multiple phase 2/3 studies with multiple formulations/doses have failed to identify a clear clinical benefit | |
Phosphorylation/protein kinase inhibitors/dephosphorylation enhancers | Lithium—multiple but some glycogen synthase kinase 3 (GSK3-β) inhibition | Phase 2 | Mild AD | NCT01055392 | 80b | NA | Clinical/cognition | Unknown | Possible stabilization of cognition in mild AD [75] |
Tideglusib-inhibitor of glycogen synthase kinase 3 (GSK3-β) | Phase 2 | AD PSP | NCT01350362 NCT00948259 | 306 | Double transgenic APP/Tau | Safety/Clinical improvement | Unknown | No clinical benefit | |
Non-specific | Davunetide—activity-dependent neurotrophic protein; decreased tau phosphorylation | Discontinued | AD PSP | NCT00422981 | 144 | ADNP transgenic mice | Safety/clinical | No | No clear cognitive benefit |
MAPT lowering (Antisense Oligonucleotide) | BIIB080 | Phase 2 | AD | NCT03186989 | 46 | P301S | Safety/Clinical | Yes | TBD |