Efficacy and safety of anti-tau drugs for Alzheimer’s disease: A systematic review and network meta-analysis - 08/11/26
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Highlights |
• | Anti-tau therapies significantly reduce cerebrospinal fluid p-tau and t-tau levels. |
• | Anti-tau therapies do not significantly improve cognitive and functional outcomes. |
• | MAPT Rx and nicotinamide improve cognitive function with the greatest efficacy. |
• | Meta-regression shows age is associated with t-tau reduction post anti-tau therapy. |
• | Anti-tau drugs are safe, except for a higher risk of injection-site reactions. |
Abstract |
Objective |
To evaluate and compare the effects of different anti-tau drugs on clinical and biological outcomes in patients with Alzheimer’s disease (AD).
Methods |
PubMed, Cochrane Library, and Embase databases were searched for identifying randomized, controlled clinical trials from inception to December 2025.
Results |
Twelve high-quality studies with 11 drugs were evaluated. Systematic meta-analysis did not demonstrate significant efficacy of anti-tau drugs in preventing cognitive and functional declines or clearance of tau deposition on PET. However, effects in reducing levels of p-tau (SMD=-0.48, 95% CI: -0.73 to -0.22, P < 0.01) and t-tau (SMD=-0.69, 95% CI: -0.94 to -0.45, P < 0.01) in the cerebrospinal fluid were observed. Network analysis revealed that MAPT Rx and nicotinamide ranked highest for improving cognitive function, and gosuranemab ranked highest for tau biomarker changes.
Conclusion |
The current findings highlight the disease-modifying potential of anti-tau therapies for AD, although clinical benefit is limited. The observed reductions in CSF tau biomarkers and the favourable safety profile of current anti-tau therapies suggest promising therapeutic potential for the treatment of AD. However, the clinical value of anti-tau therapies should be confirmed in adequately powered phase III trials with biomarker-enriched populations.
Le texte complet de cet article est disponible en PDF.Keywords : Alzheimer’s disease, Anti-tau drugs, Network meta-analysis, Meta-regression
Plan
Vol 13 - N° 10
Article 100693- décembre 2026 Retour au numéro
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