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Atabecestat is an oral, brain-permeable small molecule inhibitor of beta-site amyloid precursor protein cleaving enzyme 1 (BACE1), also known as β-secretase. By inhibiting BACE1, atabecestat reduces the production of amyloid beta (Aβ) peptides from amyloid precursor protein (APP), which are implicated in the pathogenesis of Alzheimer's disease. The drug was developed for the treatment of early-stage Alzheimer's disease and mild cognitive impairment due to Alzheimer's disease. Clinical trials demonstrated that atabecestat significantly reduced Aβ levels in cerebrospinal fluid and plasma, confirming target engagement. However, development was discontinued after reports of liver toxicity and cognitive worsening similar to other BACE inhibitors[1][2][6].
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