Burnham backs pioneering clinical trial that could speed up Alzheimer’s treatments

Prime Minister Andy Burnham has officially backed the launch of AD-SMART, a world-first clinical trial designed to accelerate the discovery of effective treatments for Alzheimer’s disease. Speaking at a conference, Burnham described the initiative as a national priority, citing the personal loss of his father, Roy, who died from the condition in September. The trial aims to test multiple existing medications simultaneously to determine if they can halt the progression of dementia, potentially reducing the time required to bring new therapies to the National Health Service by more than half. Roy Burnham, a former telephone engineer, was residing in a care home at the time of his death. Due to the severity of his illness, he was unaware that his son had assumed the role of Prime Minister. Burnham stated that he understands the devastation the disease inflicts on families firsthand. He expressed pride in seeing the trial commence in the United Kingdom, emphasizing his desire for Britain to lead global efforts in making medical breakthroughs that improve patient lives. The study, formally named the Alzheimer’s disease Systematic Multi-arm Adaptive Randomised Trial, utilizes a multi-arm, multi-stage platform design. This methodology allows researchers to test several drugs at once, comparing their efficacy against a single group of participants receiving a placebo. Unlike traditional trials, this approach ensures a higher proportion of participants receive an active treatment. Results are evaluated at regular intervals, allowing ineffective drugs to be removed from the study quickly and replaced with new candidates. This strategy minimizes the number of patients exposed to ineffective dummy drugs and accelerates the identification of viable treatments. The initial phase of the trial focuses on two repurposed medicines: metformin, commonly prescribed for type 2 diabetes, and atomoxetine, used to treat attention deficit hyperactivity disorder. An international panel of experts selected these drugs based on existing evidence suggesting they influence biological processes linked to further neurodegeneration in Alzheimer’s patients. Chief Investigator Professor Paresh Malhotra, a group leader at the UK Dementia Research Institute Centre for Care Research and Technology at Imperial College London, explained that both medications may help reduce brain inflammation, a key driver of the disease. Professor Malhotra criticized the historical pace of Alzheimer’s research, noting that it often proceeded at the rate of one drug per trial, sometimes requiring a decade or more to yield answers. By applying advancements developed for cancer and motor neurone disease, the team aims to compress this timeline significantly. The goal is to demonstrate that these treatments provide beneficial effects on cognitive function and the ability to perform daily activities, metrics that patients and carers consider most critical. Recruitment for the study involves approximately 1,200 participants with mild to moderate Alzheimer’s disease across more than 30 sites in the UK. Initial recruitment took place at the Cambridgeshire and Peterborough NHS Foundation Trust and the Surrey and Borders Partnership NHS Foundation Trust. Other active locations include facilities in London, Southampton, and Edinburgh. Researchers anticipate opening up to 20 additional NHS sites within the next 18 months. Participants will undergo regular health assessments, including cognitive tests, scans, and blood tests, to monitor the effectiveness of the treatments. Scientists expect to conclude evaluations of the first batch of drugs by 2030, during which period additional therapies, including novel Alzheimer-specific treatments, may be integrated into the trial. Angela Bucksey, 67, from Cambridgeshire, became the first participant to begin treatment under the AD-SMART protocol following her diagnosis in January. She noted that Alzheimer’s runs in her family, having affected her mother and aunts. While the diagnosis was disappointing due to anticipated lifestyle restrictions, she described feeling empowered by her participation in the trial. Her husband, Steve, who serves as her study partner, said the involvement helped move them away from the despair associated with a non-recoverable diagnosis. He observed that friends and family responded with encouragement rather than pity upon learning of their participation. Heather Ransome, 67, from the Isle of Wight, received her Alzheimer’s diagnosis in 2024. She recalled that she and her partner had been planning numerous cruises and coach holidays for their retirement. Although they continue to enjoy life, she expressed concern about the worsening of her condition. Ransome described the lack of available treatment options as upsetting, noting that the only drug previously offered had been available for many years. She stated that joining AD-SMART provides hope, describing the process as manageable since it involves taking additional daily tablets. She encouraged others who believe they are eligible to contact the trial team. Dr. Sheona Scales, director of research at Alzheimer’s Research UK, emphasized the urgency of the situation. She stated that time is precious for individuals living with Alzheimer’s disease and that there is an urgent need for more treatment options to help patients live better for longer periods and remain connected with their loved ones. The trial is spearheaded by the UK Dementia Research Institute and Alzheimer’s Research UK, with financial support from government funders. Experts indicate that the innovative design offers the potential to drastically shorten the evaluation period for Alzheimer’s drugs compared to conventional methods. The success of the trial depends on demonstrating that the tested medications alleviate symptoms such as memory impairment and thinking difficulties. While recent drugs like lecanemab and donanemab have advanced the field despite being rejected for NHS use, the focus of AD-SMART includes cheaper alternatives with known safety profiles. Professor Malhotra explained that the team intends to examine multiple mechanisms involved in the disease. By comparing treatments that affect different pathological processes driving neurodegeneration, researchers aim to identify effective interventions more rapidly. The study represents a shift toward systematic, adaptive testing to address the complex nature of Alzheimer’s disease.