Andy Burnham heralds Britain’s pioneering AD-SMART Alzheimer’s trial which could fast track first drugs shown to tackle dementia onto the NHS
Andy Burnham has welcomed the launch of a world-first trial to find drugs that tackle dementia.
The Prime Minister – whose father Roy died with the disease in September – says finding drugs that work against it is a “national priority” after decades of research failures. The national clinical trial will rapidly test a host of existing drugs to see if they halt progression of the disease which affects almost a million Brits – and if they do they will be fast-tracked for use on the NHS.
Andy Burnham said: “I know how it feels to lose a loved one to dementia and have seen first-hand the devastating impact this illness 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.
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“I have made dementia research a national priority. I want Britain to be the leading nation, making the breakthroughs that change people’s lives.”
Roy Burnham, a former telephone engineer, had been living in a care home at the time of his death. His illness meant he did not know his son had become Prime Minister.
Similar mass trials of existing drugs, which have already been proven to be safe, were used to great effect by British scientists during the pandemic to discover the first drugs that worked against Covid-19.
If found to work, it means they can be rolled out quicker so will more than halve the time it takes to test Alzheimer’s treatments.
The national trial called AD-SMART (Alzheimer’s disease Systematic Multi-arm Adaptive Randomised Trial) will start by testing the type 2 diabetes drug metformin, and the medicine atomoxetine for attention deficit hyperactivity disorder (ADHD). There is some evidence already that they affect the processes that cause further degeneration in Alzheimer’s disease.
Dr Sheona Scales, director of research at Alzheimer’s Research UK, said: “For people living with Alzheimer’s disease, time is precious. We urgently need more treatment options that can help people live better for longer and stay connected to the people they love.”
Upsetting
Heather Ransome, 67, from the Isle of Wight, was diagnosed with Alzheimer’s in 2024. She said: “Before my diagnosis, my partner and I were going on lots of cruises and coach holidays, enjoying retirement together. We still enjoy life, but I’m worried about my condition getting worse.
“I’m not the sort of person who gets upset, but being told you have Alzheimer’s is quite upsetting. There weren’t many treatment options available, and the one drug I was offered has been around for many years.
“Getting involved with AD-SMART has given me some hope for the future. It’s not too taxing, just some extra tablets to take every day. I don’t know whether I’m being given the active treatment, but if it helps me, or helps others in future, that feels positive. I would encourage anyone who thinks they might be eligible to sign up and speak to the team.”
World leading
What makes the AD-SMART trial unique in dementia research is that it is a multi-arm, multi-stage platform trial. This means several drugs are tested at the same time, and the results compared with one group of participants taking a placebo drug. More people receive an active treatment than would in a traditional trial.
Results are checked at regular stages throughout the trial and any drug that isn’t showing benefit can be dropped quickly, with new drugs added in its place. Overall this means fewer participants end up receiving ineffective dummy drugs.
The study will examine whether these medicines can lessen symptoms such as memory and thinking problems and help people maintain their quality-of-life as the disease progresses.
Chief trial investigator Prof Paresh Malhotra, of 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.
“The key thing about this trial is that when we run a single trial comparing a single intervention to a placebo… we have to build the infrastructure for it. Then we complete the trial and we take all the infrastructure down again. Someone has described that as like building a football stadium, playing a single match in it, and then taking the stadium back down again.
“What we’ve tried to do with this trial is build an infrastructure to allow us to robustly evaluate more than one treatment at a time. If there’s no evidence of a treatment working at all, we stop that treatment quickly and introduce a new treatment to test.”
The first trial participants have been recruited at Cambridgeshire and Peterborough NHS Foundation Trust and Surrey and Borders Partnership NHS Foundation Trust. Other sites include Imperial in London, Edinburgh and Southampton.
The trial will eventually be run at up to 20 NHS sites in 18 months to include more than 1,000 people. Participants will get regular scans and blood tests and the first drugs should have conclusions by 2030.
Almost a million people in the UK are living with dementia and Alzheimer’s is the most common cause, accounting for 60% to 80% of cases.
Potential disease-modifying treatments are going through clinical trials which could only be transformational if administered after very early diagnosis. Most dementia patients in the UK are still diagnosed late, if at all.
The Ad-Smart trial is led by the UK Dementia Research Institute and Alzheimer’s Research UK with support from funders including the Government.