More than 1,200 NHS patients will participate in a pioneering clinical trial launched across the United Kingdom to test whether existing diabetes and ADHD medications can slow Alzheimer’s disease. Led by the UK Dementia Research Institute and Alzheimer’s Research UK, the multi-arm study aims to halve treatment evaluation times and deliver conclusions by 2030.
A novel adaptive trial design promises to reshape how therapies for Alzheimer’s disease are evaluated in the United Kingdom. The study known as Ad-Smart (Alzheimer’s disease Systematic Multi-arm Adaptive Randomised Trial) intends to accelerate drug discovery by testing multiple treatments simultaneously against a single control group taking a placebo. Researchers expect the platform approach to test more treatments more quickly.
Ad-Smart Trial Uses Multi-Arm Platform Architecture
Conventional Alzheimer’s evaluations have historically operated on a sequential model—testing one drug in one trial, sometimes taking a decade or more. The Ad-Smart trial adopts a multi-arm, multi-stage platform architecture already deployed successfully in cancer and motor neurone disease research. Participants have a higher likelihood of receiving an active treatment than in traditional trials, and ineffective drugs can be dropped quickly to make room for new candidates.
The study starts with two existing medicines chosen by an international panel of experts alongside people with lived experience of the disease. The first starting drugs are metformin, used to treat type 2 diabetes, and atomoxetine, prescribed for attention deficit hyperactivity disorder (ADHD). Chief investigator Professor Paresh Malhotra noted that both compounds may help reduce brain inflammation, which drives neurodegeneration.
NHS Sites Aim to Enroll 1,200 Participants
Recruitment is already underway at initial National Health Service locations. The first participants have joined at Cambridgeshire and Peterborough NHS Foundation Trust and Surrey and Borders Partnership NHS Foundation Trust, while sites at Imperial College Healthcare NHS Trust, Edinburgh, and Southampton have also opened. Organizers plan to expand to up to 20 NHS sites across the UK over the next 12 to 18 months, ultimately scaling to more than 30 sites overall.
Researchers aim to enroll 1,200 participants across the country. Patients will be evaluated through regular blood tests and scans. People with a confirmed Alzheimer’s diagnosis who wish to participate can register their interest through Join Dementia Research. Professor Siddharthan Chandran highlighted that the adaptive framework allows pharmaceutical and biotech companies to feed new candidates directly into the evaluation pipeline.
Andy Burnham Makes Dementia Research a National Priority
Prime Minister Andy Burnham backed the launch, noting personal family experience with the condition following the death of his father, Roy, from Alzheimer’s in September. Prime Minister Andy Burnham stated that he had made dementia research a national priority. The initiative is supported by a £48 million partnership supporting The BARBARA Alliance, including £33 million from the Government plus contributions from industry partners.
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.
Professor Paresh Malhotra, UK Dementia Research Institute
Medical leaders across the health sector welcomed the funding push. Senior officials at the Birmingham and Solihull Mental Health NHS Foundation Trust noted that dementia care has historically competed against other major health categories for funding under a broader frailty umbrella. Clinical leaders emphasize that dedicated national focus is necessary to shorten assessment waiting times and handle complex patient needs.
Initial Drug Evaluation Projected to Finish by 2030
The evaluation of the initial drug pair is projected to finish in 2030, in around four years’ time. With around 600,000 people affected by Alzheimer’s across the UK, researchers stress that faster testing pipelines remain critical for patient care.