Healthy middle-aged people without memory loss will be offered an experimental Alzheimer's drug that could stop the condition from developing before dementia symptoms emerge. The trial is being run by an NHS trust as part of an international clinical study aiming to prevent dementia.
The first European participants in the trial, which is recruiting about 1,600 people aged 55 to 80 from around the world, will be screened on Monday by the Surrey and Borders Partnership NHS foundation trust. Participants from across the UK will be tested to ensure they have no memory problems before being offered a blood test to assess whether they have p-tau217, a biomarker that can predict cognitive decline and the development of Alzheimer's.
Key trial details and screening process
Previous research found that people with the highest levels of p-tau217 had an estimated 78% chance of developing cognitive impairment within 10 years. Research has also shown that blood tests measuring p-tau217 could identify Alzheimer's disease with up to 95% accuracy.
The phase III trial, called the PrevenTRON study, will investigate whether prescribing a new drug, Trontinemab, to participants who have elevated levels of p-tau217 and meet the trial criteria can stop dementia developing in the first place. Trontinemab, developed by the Swiss pharmaceutical company Roche, attacks amyloid plaques—a toxic protein that builds up in the brain, slowing down and eventually killing brain cells.
Groundbreaking drug and research shift
Trontinemab has been hailed as a groundbreaking drug after early research found it cleared amyloid plaques in nine out of 10 people with early-stage Alzheimer's or mild cognitive development within 28 weeks, meaning one of the key characteristics of Alzheimer's was removed.
Prof Ramin Nilforooshan, consultant psychiatrist and chief investigator for the PrevenTRON trial, said the study demonstrates how researchers are shifting their focus from cure to prevention: "For decades, research has focused on treating Alzheimer's disease after symptoms appear. PrevenTRON addresses a different question, whether we can act earlier, before symptoms begin." Through research and trials such as PrevenTRON, he said there was the potential to help millions of people affected by Alzheimer's.
Experimental nature and next steps
However, he stressed in an interview with the Telegraph the experimental nature of the treatment. "I'm not saying this trial is magic. It's an investigational medicine. We need to wait and see: will it work or not?" he said.
At least 15 hospitals and clinics across the UK are expected to take part in the study by the end of the year, with recruitment led by the Surrey and Borders Partnership Trust. The trial is expected to last four to six years. Participants will be randomly assigned to receive either Trontinemab or a placebo, and will then be monitored to see how quickly they develop any signs of dementia.
Alzheimer's disease is thought to develop inside the brain up to 10 years before people typically seek treatment for memory problems. It affects around one in 14 people over the age of 65 and one in six people over the age of 80. Those interested in being screened for the trial can contact the Surrey and Borders Partnership research team on 01372 216584 or at research@sabp.nhs.uk.
