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Gosuranemab is a humanized IgG4 monoclonal antibody developed as an immunotherapy targeting the N-terminal region of the tau protein. It was designed to bind extracellular tau, including full-length and N-terminal fragments, with high affinity, thereby inhibiting tau seeding activity and potentially limiting the spread of pathological tau between neurons. Gosuranemab was investigated for neurodegenerative diseases characterized by abnormal tau accumulation, such as progressive supranuclear palsy (PSP) and Alzheimer's disease. Despite demonstrating robust target engagement—marked by significant reductions in unbound N-terminal tau in cerebrospinal fluid—gosuranemab failed to show clinical efficacy in large phase 2 trials for both PSP and Alzheimer's disease. Development has been discontinued for these indications due to lack of efficacy[1][2][3][5][6].
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