- Rynearson, Kevin D;
- Ponnusamy, Moorthi;
- Prikhodko, Olga;
- Xie, Yuhuan;
- Zhang, Can;
- Nguyen, Phuong;
- Hug, Brenda;
- Sawa, Mariko;
- Becker, Ann;
- Spencer, Brian;
- Florio, Jazmin;
- Mante, Michael;
- Salehi, Bahar;
- Arias, Carlos;
- Galasko, Douglas;
- Head, Brian P;
- Johnson, Graham;
- Lin, Jiunn H;
- Duddy, Steven K;
- Rissman, Robert A;
- Mobley, William C;
- Thinakaran, Gopal;
- Tanzi, Rudolph E;
- Wagner, Steven L
A potent γ-secretase modulator (GSM) has been developed to circumvent problems associated with γ-secretase inhibitors (GSIs) and to potentially enable use in primary prevention of early-onset familial Alzheimer's disease (EOFAD). Unlike GSIs, GSMs do not inhibit γ-secretase activity but rather allosterically modulate γ-secretase, reducing the net production of Aβ42 and to a lesser extent Aβ40, while concomitantly augmenting production of Aβ38 and Aβ37. This GSM demonstrated robust time- and dose-dependent efficacy in acute, subchronic, and chronic studies across multiple species, including primary and secondary prevention studies in a transgenic mouse model. The GSM displayed a >40-fold safety margin in rats based on a comparison of the systemic exposure (AUC) at the no observed adverse effect level (NOAEL) to the 50% effective AUC or AUCeffective, the systemic exposure required for reducing levels of Aβ42 in rat brain by 50%.