The upcoming Alzheimer’s Association International Conference in London will focus on a shift in Alzheimer’s disease treatment strategies, with increasing attention on tau-targeted therapies alongside established amyloid treatments, according to a July 10 report.
Al Sandrock, CEO of Voyager Therapeutics, said, “We’re at the dawn of disease-modifying treatments.” The approval of Eisai and Biogen’s Leqembi in 2023 and Eli Lilly’s Kisunla in 2024 marked the introduction of drugs that clear amyloid plaque. However, questions remain about their safety and efficacy. Sandrock said the field is now looking toward earlier treatment with anti-amyloid drugs and exploring tau as the next significant target for intervention.
Tau tangles have long been considered another hallmark of Alzheimer’s disease. Biogen’s tau-targeting candidate diranersen will be featured at AAIC. Andrew Tsai, analyst and managing director at Jefferies, said, “I think tau thematically could make a splash this year,” noting that these therapies may avoid brain swelling associated with anti-amyloid drugs. Early attempts at targeting tau have faced setbacks; Johnson & Johnson recently halted a Phase 2 trial for its candidate posdinemab due to lack of efficacy but will present full data at AAIC.
Paul Matteis, managing director at Stifel, expressed interest in seeing full data from Biogen's mid-stage study on diranersen: “About 90% of my focus is going to be on this full Biogen tau data.” Laura Nisenbaum from the Alzheimer’s Drug Discovery Foundation commented, “This is the first time that we’re seeing a tau targeting drug have an effect both on biology as well as a potential signal on the clinical effects … and this is the first signal that we might be able to move beyond amyloid.”
Voyager Therapeutics’ gene therapy candidate VY1706 recently received clearance for clinical trials and aims to cross the blood-brain barrier using capsid technology. Sandrock said, “With [VY1706], you could have a one-time gene therapy that is a potential game-changer.”
While new approaches are emerging, anti-amyloid drugs like Leqembi remain central to current treatment options. Eisai Chief Clinical Officer Lynn Kramer stated that long-term studies show these drugs work best in early-stage patients and highlighted decreasing rates of brain swelling side effects over time. Smaller companies such as ProMIS Neurosciences are also developing new amyloid-focused candidates aimed at reducing side effects.
