Abstract

AbstractThe gingipain inhibitor atuzaginstat is a novel protease inhibitor that blocks a neurotoxic virulence factor known to trigger AD pathogenesis. Because the link between periodontal disease and AD is mechanistic and not incidental, it seems logical to develop drugs that target the virulence factors of P. gingivalis infection, such as gingipains. Atuzaginstat is appealing because it is orally bioavailable and blood–brain barrier penetrant. Clinical trials of atuzaginstat have been completed, with no evidence of amyloid‐related imaging abnormalities. However, a hepatotoxic signal has emerged that requires monitoring and could potentially influence further development of this potential treatment. Since the patients most likely to benefit from the results of the clinical trials underway are those with mild‐to‐moderate AD, more studies are being planned. Atuzaginstat can address the ongoing need for treatment for most patients for whom anti‐amyloids are not suitable.

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