Imperial-DRI collaboration for novel Alzheimer’s disease trial

Imperial researchers working in collaboration with Dementia Research Institute UK (DRI) are running a new, faster kind of clinical trial for Alzheimer’s disease. Around 982,000 patients in the UK suffer from dementia. Alzheimer’s, which affects approximately 11% of people above 65, is the leading cause. There are currently 158 substances being tested as putative Alzheimer’s treatments worldwide; yet, despite intense investment in dementia drug development, the NHS does not currently offer any treatments that stop the development of this disease. Most conventional trials are done by comparing the outcomes of a group of patients on a dummy pill, called a placebo, to another group, taking a single drug. The AD-SMART trial will only have one group on a placebo, and two different groups taking different drugs. Thanks to this approach, a larger percentage of patients is taking an active substance.

The trial lasts only four years, and the drugs that don’t work in first 18 months will be replaced with new drugs. Drugs will be assessed based on patients’ performance on cognitive tests as well as their ability to perform basic tasks like showering.

To further speed up the transition between clinical trial and drug availability to patients, the drugs in AD-SMART are already approved for other conditions. They show promise in treating dementia, and have already been shown to be safe. If they perform well, they should be relatively easy to approve. This is a common approach for Alzheimer’s trials – 35% of clinical trials in 2026 target ‘repurposed’ drugs.

“We are applying advances from cancer and other conditions to accelerate testing of treatments for people with Alzheimer’s disease,” Professor Palesh Malhotra, the chief investigator, explained. The SMART approach has already been effective for motor neuron disorders, discounting a medication’s effectiveness especially quickly and allowing researchers to focus their attention more efficiently.