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BACE1 inhibitors: Current status and future directions in treating Alzheimer's disease

Moussa‐Pacha, Nour M., Abdin, Shifaa M., Omar, Hany A., Alniss, Hasan, Al‐Tel, Taleb H.·2020·Medicinal Research Reviews
DOI 10.1002/med.21622
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Abstract

Alzheimer's disease (AD) is an irreversible, progressive neurodegenerative brain disorder with no current cure. One of the important therapeutic approaches of AD is the inhibition of β‐site APP cleaving enzyme‐1 (BACE1), which is involved in the rate‐limiting step of the cleavage process of the amyloid precursor protein (APP) leading to the generation of the neurotoxic amyloid β (Aβ) protein after the γ‐secretase completes its function. The produced insoluble Aβ aggregates lead to plaques deposition and neurodegeneration. BACE1 is, therefore, one of the attractive targets for the treatment of AD. This approach led to the development of potent BACE1 inhibitors, many of which were advanced to late stages in clinical trials. Nonetheless, the high failure rate of lead drug candidates targeting BACE1 brought to the forefront the need for finding new targets to uncover the mystery behind AD. In this review, we aim to discuss the most promising classes of BACE1 inhibitors with a description and analysis of their pharmacodynamic and pharmacokinetic parameters, with more focus on the lead drug candidates that reached late stages of clinical trials, such as MK8931, AZD‐3293, JNJ‐54861911, E2609, and CNP520. In addition, the manuscript discusses the safety concerns and insignificant physiological effects, which were highlighted for the most successful BACE1 inhibitors. Furthermore, the review demonstrates with increasing evidence that despite tremendous efforts and promising results conceived with BACE1 inhibitors, the latest studies suggest that their clinical use for treating Alzheimer's disease should be reconsidered. Finally, the review sheds light on alternative therapeutic options for targeting AD.

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  • Several BACE1 inhibitory drugs have been developed, yet despite progression to phase 3 clinical trials, none have made it to wide clinical use.

    “Several BACE1 inhibitory drugs have been developed, yet despite progression to phase 3 clinical trials, none have made it to wide clinical use.”

    From BACE1: More than just a β‐secretase (2022) · cites this paper as [185]

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Metadata

Authors
Moussa‐Pacha, N. M., Abdin, S. M., Omar, H. A., Alniss, H., & Al‐Tel, T. H.
Affiliations
Sharjah Institute for Medical Research University of Sharjah Sharjah United Arab Emirates
ORCID
Venue
Medicinal Research Reviews
Publisher
Wiley
Published
2019-07-26
Volume
40
Issue
1
Pages
339-384
ISSN
  • 0198-6325
  • 1098-1128
DOI
10.1002/med.21622
Cited by
274
References
34
Language
en
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)

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