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Tadalafil reduces some plasma neurodegeneration biomarkers in type 2 diabetes patientsSmall study finds tadalafil may lower some Alzheimer's biomarkers in diabetes patients

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Key Takeaway
Note preliminary biomarker changes with tadalafil in a small T2D cohort; clinical relevance is unknown.

This was a post-hoc analysis of a 6-week, single-center randomized controlled trial conducted at Sahlgrenska University Hospital. The study included 15 individuals with type 2 diabetes who were randomized to receive either the PDE-5 inhibitor tadalafil or a placebo. The analysis focused on plasma biomarkers associated with Alzheimer's disease pathology.

Compared to placebo, 6 weeks of tadalafil treatment was associated with reductions in plasma amyloid-β 40, amyloid-β 42, and glial fibrillary acidic protein (GFAP). The amyloid-β 42/40 ratio, phosphorylated tau217 (p-tau217), neurofilament light protein (NfL), and growth/differentiation factor 15 (GDF-15) showed no significant reduction. No effect sizes, absolute numbers, or p-values/confidence intervals for these changes were reported.

Safety and tolerability data were not reported for this post-hoc analysis. Key limitations include its nature as a post-hoc analysis, a very small sample size of 15 participants, the use of biomarker outcomes only, and a short follow-up period of 6 weeks. The clinical significance of these plasma biomarker changes is unknown.

This analysis generates a hypothesis that tadalafil may influence certain plasma biomarkers of neurodegeneration in people with type 2 diabetes. The findings are preliminary and do not demonstrate clinical efficacy for Alzheimer's disease. Further research is needed to confirm these observations and understand their potential relevance.

Researchers conducted a small study to see if a medication called tadalafil could affect blood markers related to Alzheimer's disease in people with type 2 diabetes. The study involved only 15 people who were given either tadalafil or a placebo for six weeks. The researchers then looked at several proteins in the blood that are associated with brain changes in Alzheimer's.

They found that people taking tadalafil had lower levels of two amyloid proteins and one protein called GFAP compared to those taking the placebo. However, other important markers, including one called p-tau217, did not change. The study did not report on side effects or whether people felt any different.

It is important to be very cautious about these results. This was a very small study that only measured blood markers for a short time. It does not tell us if tadalafil improves memory, slows Alzheimer's disease, or is safe for this purpose. The changes in biomarkers are a first step that needs much more research in larger groups over longer periods.

For now, this study simply suggests that tadalafil might influence some biological signals related to Alzheimer's in people with diabetes. It is far too early to consider this a treatment. More research is needed to understand what these biomarker changes mean for brain health.

What this means for you:
A very small, early study found tadalafil changed some Alzheimer's blood markers in diabetes patients, but its effect on the disease is unknown.

Study Details

Study typeRct
EvidenceLevel 2
Follow-up1.4 mo
PublishedApr 2026
View Original Abstract ↓
Phosphodiesterase-5 (PDE-5) inhibitors may be beneficial in Alzheimer's disease (AD). We assessed the PDE-5 inhibitor tadalafil effect on plasma biomarkers of neurodegeneration in 15 individuals with type 2 diabetes post-hoc in a randomized placebo-controlled trial (ClinicalTrials.gov: NCT02601989) at Sahlgrenska University Hospital. Tadalafil reduced plasma amyloid-β 40 and 42 but not the 42/40 ratio over a 6-week treatment period. Glial fibrillary acidic protein was reduced, but not phosphorylated tau217, neurofilament light protein or growth/differentiation factor 15. Tadalafil reduced plasma levels of biomarkers for amyloid metabolism and astroglial activation in patients with diabetes. Designated clinical trials are warranted to validate these results.
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