December 18, 2025

@michaelokun

Should we use antiviral therapy for Alzheimer’s? A new randomized study in JAMA says NO. An antiviral is a medication designed to block viruses from infecting cells or multiplying in the body. Devanand and colleagues just dropped a new randomized clinical trial in JAMA examining whether valacyclovir, an antiviral used for herpes infections, could slow early symptomatic Alzheimer’s disease. Key Points: - Valacyclovir did not improve thinking or daily function compared to placebo. - Participants receiving valacyclovir experienced greater cognitive worsening on the primary outcome measure. - Brain imaging showed no meaningful reduction in amyloid or tau buildup. - “The 11-item Alzheimer’s Disease Assessment Scale Cognitive Subscale score (range, 0-70; higher scores indicate greater impairment) at 78 weeks was 10.86 in the valacyclovir group vs 6.92 in the placebo group, which was a significant difference favoring placebo.” My take: Epidemiological and electronic health records have suggested that herpes simplex virus could worsen Alzheimer’s. Why not just give an antiviral therapy to slow progression or treat symptomatically? This study is a great example of why clinical trials are important. Not only was Valacylcovir not effective, it worsened symptoms. Here are 5 points that resonated w/ me: 1- A strong idea still needs strong trials, and this one did not support antiviral treatment for Alzheimer’s. 2- Treating herpes virus activity did not slow memory decline in early Alzheimer’s. 3- More medication is not always better, and sometimes can lead to harm. 4- Imaging results matched the clinical story, revealing no evidence of slowing of disease. 5- Studies like this will aid health care providers and folks in avoiding ineffective and potentially harmful therapies. https://cutt.ly/utaOko0Z #michaelokun #alzheimer #alzheimersassociation #fixelinstitute