CPFT's research team has successfully enrolled the initial participants into a new UK-wide trial designed to expedite the discovery of effective treatments for Alzheimer's disease. Alzheimer's, the most common form of dementia, affects approximately 600,000 individuals in the UK. CPFT is actively conducting specialist clinical trials across Cambridgeshire, Peterborough, and the wider East of England, aiming to identify NHS treatments that can slow or halt the progression of the underlying disease.
The AD-SMART (Alzheimer’s disease Systematic Multi-arm Adaptive Randomised Trial) is a pioneering national trial testing multiple drugs simultaneously. It initially focuses on two repurposed medicines currently used for type 2 diabetes and attention deficit hyperactivity disorder (ADHD). Participants will receive different drugs in groups to assess their potential to alleviate symptoms such as memory and thinking problems, and to help maintain quality of life as the disease advances.
Cambridgeshire residents Angela and Steve Bucksey were among the first to enrol in the AD-SMART trial with CPFT's dementia research experts. They stated, “Following Angela’s diagnosis, we decided to take part in a study at a local friendly research unit without having to travel into London, and it feels good to be doing something about it. By taking part we hope to be among the first to hear about the latest developments and access treatments that could help Angela and maintain the best quality of life. We would encourage anyone to join as it’s so easy and the team are great people to work with, you can talk to them openly and they understand everything about the disease and how to support us – you are in good hands!”
Dr Ben Underwood, CPFT’s Research and Development Director and local principal investigator for AD-SMART in Cambridge, expressed his delight: “We are delighted to welcome Angela and Steve to join the trial with us at CPFT and hope this research will directly benefit them and countless others living with Alzheimer’s disease. Our research would not be possible without people like them coming forward to help us. We will support them throughout their research journey and hope that many others will join to help test promising dementia treatments and ensure the most successful ones can be brought to NHS clinics as soon as possible. This type of trial could rapidly improve treatment for people living with dementia and our specialist team have worked hard to set it up at CPFT.”
AD-SMART employs a multi-arm, multi-stage platform trial design, where several drugs are tested concurrently against a shared placebo group. This approach allows for more participants to receive active treatment compared to traditional trials. Results are reviewed at regular intervals, enabling ineffective drugs to be dropped quickly and new ones to be introduced, thereby minimising the number of participants receiving ineffective treatments. This method can more than halve the evaluation time for treatments and reduce costs.
By testing drugs already approved for other conditions and known to be safe, successful treatments can reach Alzheimer's patients faster than those developed from scratch. The trial also accommodates new potential treatments emerging from the research pipeline.
The AD-SMART trial is led by the UK Dementia Research Institute (UK DRI) and Alzheimer's Research UK (ARUK), in collaboration with the National Institute for Health and Care Research (NIHR), the Medical Research Council (MRC), and Health Data Research UK (HDR UK). The trial is supported by ongoing funding from the UK government.
Professor Paresh Malhotra, National Chief Investigator and Group Leader at the UK DRI Centre for Care Research and Technology at Imperial College London, commented: “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. The way AD-SMART is set up means we’re testing several treatments at the same time, and those that don’t show promise can be quickly stopped. Then we can start testing something else. That’s the best way to get effective treatments to patients as quickly as we can.”
In addition to CPFT, up to 20 NHS sites are expected to open across the UK within the next 12-18 months, with over 30 planned in total. Researchers aim to recruit 1,200 participants nationwide to test the initial two drugs. The evaluation of these first drugs is anticipated to conclude in 2030, approximately four years from now. During this initial four-year period, additional drugs are expected to be incorporated into the trial.
The two starting drugs were selected by an international panel of experts and individuals with lived experience of Alzheimer's, based on evidence from earlier patient studies and laboratory research. People with lived experience, working with teams at CPFT and the University of Cambridge, have significantly shaped the trial's design, including the choice of drugs and success metrics. The POrtal for Patient and Public Engagement in Dementia research (POPPED) was developed with Dr Ben Underwood to help individuals influence future dementia studies.
Individuals with a confirmed Alzheimer's diagnosis interested in participating can contact the CPFT Research team at RandD@cpft.nhs.uk or call 01223 219753. To register for this study and explore other opportunities in groundbreaking dementia treatment trials, visit Join Dementia Research.
