New Alzheimer's trial could halve treatment discovery time

A new clinical trial named Ad-Smart has begun in the UK, designed to significantly accelerate the development of treatments for Alzheimer's disease. This innovative approach tests multiple drugs concurrently, a method experts believe could more than halve the time traditionally needed to identify effective therapies. The trial is being led by the UK Dementia Research Institute and Alzheimer’s Research UK, with government backing.

Simultaneous Drug Testing

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The Ad-Smart trial will initially evaluate two drugs: metformin, commonly used for type 2 diabetes, and atomoxetine, prescribed for attention deficit hyperactivity disorder (ADHD). Researchers have noted existing evidence suggesting atomoxetine may influence the processes that contribute to Alzheimer's degeneration, while metformin has also shown promise in certain biological pathways. The trial design allows for new drugs, including those specifically developed for Alzheimer's, to be added over time.

Professor Paresh Malhotra, chief investigator from the UK Dementia Research Institute, explained the limitations of previous research methods. "For too long, Alzheimer’s research has moved at the pace of one drug, one trial, one answer, sometimes taking a decade or more before we know if we’ve found something that works," Professor Malhotra stated. He added that the Ad-Smart setup enables the rapid discontinuation of treatments that show no promise, allowing for the swift introduction of new candidates. This systematic approach aims to identify effective treatments much faster.

Recruitment and Expansion

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The first participants for the Ad-Smart trial have been recruited at Cambridgeshire and Peterborough NHS Foundation Trust and Surrey and Borders Partnership NHS Foundation Trust. The initiative plans to expand significantly, with up to 20 NHS sites expected to become involved over the next 18 months. This expansion aims to recruit more than 1,000 individuals for the study. Initial conclusions regarding the efficacy of the first drugs tested are anticipated by 2030.

Professor Siddharthan Chandran, director of the UK Dementia Research Institute, described the current period as "a very exciting time" for Alzheimer's research, noting advancements in diagnostics and potential treatments. He highlighted that past testing methods were "grossly inefficient," often taking four to five years to determine a drug's effectiveness. The Ad-Smart trial's adaptive design is intended to facilitate the quicker integration of drugs from biotech and pharmaceutical companies, potentially making a significant difference for those living with Alzheimer's.

Dr. Sheona Scales, director of research at Alzheimer’s Research UK, emphasised the urgency for new treatment options. "For people living with Alzheimer’s disease, time is precious," Dr. Scales said. She expressed hope that the new trial approach will hasten the arrival of a future with more treatment choices and ultimately, a cure for the disease.