Limited evidenceBrain & cognition

Homotaurine

An amyloid-binding compound (also known as tramiprosate) that failed its large Alzheimer's trial. What remains is a post-hoc signal in APOE4 carriers and a few small studies in mild cognitive impairment.

Evidence last reviewed: August 2026

What the science says

No benefit in a large Alzheimer's trial Moderate evidence
The Alphase study randomized over 1,000 patients with mild-to-moderate Alzheimer's disease to tramiprosate or placebo for 18 months and found no significant effect on cognition or global function. This is the largest and most informative trial of the compound.
Post-hoc signal in APOE4 homozygotes Limited evidence
Re-analyses of the same failed trial reported a cognitive benefit concentrated in patients carrying two APOE4 alleles. These are exploratory subgroup analyses of a negative study and have not been confirmed prospectively.
Small studies in mild cognitive impairment Limited evidence
Small open studies in people with mild cognitive impairment have reported changes in inflammatory markers such as IL-33 and IL-10 after homotaurine. Biomarker shifts in tiny samples say nothing reliable about memory.

Dosage & safety

Studied doseThe Alzheimer's trials used 100–150 mg twice daily. Supplements typically supply 50–100 mg per day, below the studied dose.

SafetyNausea, vomiting and dizziness were the common adverse effects in trials. It is regulated as a supplement in some countries and as an investigational drug in others. Not appropriate as a substitute for medical treatment of dementia, and untested in pregnancy.

Scientific references

Tramiprosate in mild-to-moderate Alzheimer's disease - a randomized, double-blind, placebo-controlled, multi-centre study (the Alphase Study)
Aisen PS, Gauthier S, Ferris SH — Arch Med Sci, 2011
Clinical Benefits of Tramiprosate in Alzheimer's Disease Are Associated with Higher Number of APOE4 Alleles: The "APOE4 Gene-Dose Effect"
Abushakra S, Porsteinsson A, Vellas B — J Prev Alzheimers Dis, 2016
IL-33 and IL-10 Serum Levels Increase in MCI Patients Following Homotaurine Treatment
Toppi E, Sireno L, Lembo M — Front Immunol, 2022

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