Could a Medication Potentially Delay the Onset of Alzheimer's Disease for Several Decades?
In a groundbreaking clinical trial, researchers are exploring a potentially life-changing treatment for Alzheimer's disease. This pioneering study, titled the Primary Prevention Trial, is being led by scientists at the Washington University School of Medicine. The trial's focus is on individuals genetically predisposed to the devastating brain disorder, with a high risk of early onset Alzheimer's.
The primary candidate in this trial is an experimental antibody called remternetug, developed by Eli Lilly. This drug is intended to serve as a successor to Eli Lilly's donanemab (Kisunla), which was approved for early Alzheimer's disease treatment in July 2024. Both remternetug and donanemab target a misfolded protein named amyloid beta, which forms harmful plaques in the brains of those with Alzheimer's.
While current anti-amyloid drugs show modest effects on delaying the progression of Alzheimer's, research suggests that they could be much more potent—even preventing Alzheimer's altogether—if administered to high-risk individuals during their early years. This trial aims to test this hypothesis directly, providing invaluable insights into Alzheimer's and potentially revolutionizing the way we approach this debilitating condition.
The Primary Prevention Trial will involve 240 participants from families with genetic mutations associated with early-onset Alzheimer's. These mutations include APP, PSEN1, and PSEN2, typically causing the disease to appear in the 30s, 40s, or 50s. Participants will be assigned to receive remternetug or a placebo every three months over a two-year period. After the initial trial, participants may choose to continue taking remternetug in an open-label trial extension for another four years.
Researchers anticipate that the trial's participants may not exhibit noticeable cognitive changes during the study. However, they will monitor the build-up of amyloid plaque in participants' brains to assess the drug's impact. Such a trial provides an extraordinary opportunity to learn more about Alzheimer's and potentially devise better prevention and treatment strategies for all forms of the disease.
One notable participant in the trial is Hannah Richardson, a 24-year-old whose family has been severely affected by Alzheimer's. In her statement, she expressed her gratitude for being able to contribute to research and help and her family and future generations.
By 2034, researchers expect to have reported findings from the trial's first placebo-controlled stage. They plan to continue monitoring patients for many years afterward, leveraging the lessons learned to improve our understanding of early-onset and classic Alzheimer's disease.
As Maria C. Carrillo, chief science officer at the Alzheimer's Association, noted, this trial has the potential to significantly impact Alzheimer's prevention by saving individuals and families from the anguish caused by the disease. The Primary Prevention Trial represents a significant milestone in the fight against Alzheimer's and the hope for a future without this debilitating disease.
The potential success of remternetug in preventing Alzheimer's altogether, as suggested by recent research, could significantly shift the role of science and technology in healthcare, offering a promising future for those genetically predisposed to the disease. With breakthroughs like this Primary Prevention Trial, the field of neurology may witness a revolution, transforming how we combat and manage conditions like Alzheimer's.
