A secretase inhibitor should just keep new amyloid from being formed and deposited
It is never that simple that something does just this or that. Semagacestat indeed reduces Aß concentrations in the plasma but had little impact on CSF level and BMS-708163 didn't do a lot better on this biomarker. However, changing the blood/CSF/brain equilibrium in Aß concentrations could well affect the removal of amyloid from the brain. This might cause more accumulation in the vasculature due to higher Aß burden and/or inefficient clearance or other unknown mechanism.
I guess that would leave tau as the next batter up.
I'm a tauist myself but so far no meaningful clinical data in this arena and think they are still a few years away.
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