A large UK study has been launched to test several drugs for Alzheimer’s disease that are already being used for other conditions.
The multi-arm adaptive randomised controlled trial being run across 30 NHS sites when fully operational will initially test metformin and atomoxetine with results expected by 2030.
It is designed with multiple medicines being tested against one placebo group with regular checks on the impact on memory, cognition and quality of life so that the repurposed medicines can be dropped if showing no evidence of benefit and replaced with another candidate.
But the trial is also designed to test new potential treatments coming through the research pipeline.
Backed by Government funding, AD-SMART (Alzheimer’s disease Systematic Multi-arm Adaptive Randomised Trial) it is led by the UK Dementia Research Institute and Alzheimer’s Research UK and is looking to recruit 1,200 patients.
The approach could halve the time it takes for an effective treatment to reach patients, those running the trial believe.
Study lead Professor Paresh Malhotra, group leader at the UK DRI Centre for Care Research and Technology at Imperial College London, said: ‘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.
‘We are applying advances from cancer and other conditions to accelerate testing of treatments for people with Alzheimer’s disease.’
Prime Minister Andy Burnham, whose father recently died from the condition, said he had seen first-hand the devastating impact the disease 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 first trial participants have been recruited at Cambridgeshire and Peterborough NHS Foundation Trust and Surrey and Borders Partnership NHS Foundation Trust.
Sites based at Imperial College Healthcare NHS Trust, Edinburgh and Southampton are also now open.
Up to 20 NHS sites are expected to open across the UK over the next 12 to 18 months.
A similar model was used for MND-SMART, a platform trial for motor neuron disease, also led by the UK DRI, which concluded that its first drugs tested were ineffective in just over three years rather than the eight the process would usually take and has moved on to other medicines.
A report from The King’s Fund and Alzheimer’s Society published in September warned that dementia care is stuck in the 20th century and needs a ‘cancer-style revolution’.
It comes as NHS England announced it had reached its target for diagnosing more than two thirds of people with dementia for the first time since before the Covid-19 pandemic.
Dr Jeremy Isaacs, national clinical director for dementia, NHS England, said figures showed 523,081 people have a dementia diagnosis compared to 470,292 people in March 2020 when the dementia target was previously hit.
‘As the number of people with dementia continues to rise, it’s vital that we look at how we can provide a fitting and sustainable way to deliver long-term care for people with this devasting disease who are sometimes overlooked, which is why we are working with government to develop a national vision for dementia care,’ he added.
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