UK trial 'could halve time to test Alzheimer's drugs'

A major new UK trial has been launched to try to find new therapies for Alzheimer's disease more quickly, starting with two generic drugs currently used to treat diabetes and attention deficit hyperactivity disorder (ADHD).

The AD-SMART trial – which has started to recruit people aged over 55 with a diagnosis of Alzheimer's or mixed dementia – could more than halve the time usually taken to test Alzheimer's treatments, according to the Alzheimer's Research UK charity, which is co-leading the trial alongside the UK Dementia Research Institute (DRI).

UK Prime Minister Andy Burnham, who lost his father to Alzheimer's earlier this year, said: "I know how it feels to lose a loved one to dementia and have seen first-hand the devastating impact this illness has on families. That's why I'm proud to see this trial being launched in the UK, so that cutting-edge treatments can reach patients here as soon as possible."

The study is taking a 'basket' approach to testing, and will test medicines in parallel, starting with type 2 diabetes stalwart metformin and well-established ADHD therapy atomoxetine. Both drugs are thought to reduce inflammation in the central nervous system, a driver of neurodegeneration.

The study will examine whether these repurposed medicines – and eventually novel candidates coming through development – can lessen symptoms such as memory and cognitive impairments, and help people maintain their quality of life as the disease progresses.

It's a model that has already been tested in the MND-SMART study of potential repurposed therapies for motor neuron disease (MND), which launched in 2020 and has tested three drug candidates so far. Unfortunately, all of those (amantadine, memantine, and trazodone) proved ineffective, but the adaptive design means that they can be quickly dropped and others added (tacrolimus) without needing to launch a new study.

MND-SMART delivered its verdict on the first three candidates in three years, well below the eight years it would have taken with conventional trial designs, said the DRI.

Patients have already been recruited at sites run by two NHS trusts, and three others are now open for recruitment, with an objective of having 30 over the next 18 months or so.

Around 1,200 participants will be needed to test the first two treatments, with results due in 2030, and additional therapies will be added to AD-SMART in the intervening four-year period.

Heather Ransome (67), from the Isle of Wight, was diagnosed with Alzheimer's in 2024, and is among the first patients to enrol for AD-SMART.

"Before my diagnosis, my partner and I were going on lots of cruises and coach holidays, enjoying retirement together. We still enjoy life, but I'm worried about my condition getting worse," she said.

"There weren't many treatment options available, and the one drug I was offered has been around for many years. Getting involved with AD-SMART has given me some hope for the future."

Earlier this month, the UK said it was putting £80 million in funding behind nine technologies that it hopes will be able to diagnose different forms of dementia, including Alzheimer's, more quickly. The target is to ensure that 92% of people are diagnosed within 18 weeks of a referral, so they can receive care and treatment more quickly.

Photo by Shubham Dhage on Unsplash