New Multi-Arm, Multi-Stage UK Trial to Test Alzheimer Treatments

The Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) has initiated a multi-arm, multi-stage platform trial—AD-SMART (Alzheimer disease Systematic Multi-arm Adaptive Randomised Trial)—to find better treatments for individuals with Alzheimer disease.

This trial is the first of its kind to test multiple drugs simultaneously, starting with 2 repurposed medications already used to treat type 2 diabetes and attention-deficit/hyperactivity disorder (ADHD). Groups of trial participants will be randomly assigned to one of the 2 medications or placebo. Investigators will then determine whether these medications can lesson symptoms like memory and thinking problems and help people maintain their quality of life as their disease progresses.

“For too long, Alzheimer’s research has moved at the pace of 1 drug, 1 trial, 1 answer, sometimes taking a decade or more before we know if we have found something that works. We are applying advances from cancer and other conditions to accelerate testing of treatments for people with Alzheimer 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,” said Paresh Malhotra, PhD, a national chief investigator and group leader at the UK Dementia Research Institute Centre for Care Research and Technology at Imperial College London.

More About AD-SMART

The 2 initial drugs to be used in the trial were selected by an international panel of experts and individuals with lived experience of Alzheimer disease. Their decisions were rooted in evidence from earlier stage studies and laboratory research. People with lived experience, alongside a team at CPFT and the University of Cambridge, also got a say in success measures.

Results will be checked at regular stages throughout the trial. Any drug that is not showing benefit can be dropped quickly and replaced with new medications. Essentially, this means fewer participants end up receiving ineffective drugs and the time to evaluate treatments can be significantly reduced.

As the tested drugs are already approved for other conditions and known to be safe, if any prove successful for the treatment of Alzheimer disease, time to a secondary approval is significantly shortened compared with the development of an entirely new drug. The trial is also designed to test new potential treatments coming through the research pipeline.

Up to 20 NHS sites are expected to open across the UK over the next 12-18 months, with more than 30 planned sites overall. Investigators hope to recruit 1200 participants across the UK to test the first 2 drugs. The first drugs’ evaluation will be finished in 2030. During this initial 4-year period, the team expect additional drugs to be added into the trial for testing.

Insights From Participants

Cambridgeshire residents Angela and Steve Bucksey chose to take part in AD-SMART. They shared their reasons behind joining the trial, and the benefits of being able to do so locally: “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!”

“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,” said Ben Underwood, MD, PhD, CPFT’s research and development director and local principal investigator for AD-SMART.

References

1. First participants join major UK trial to test Alzheimer’s treatments with CPFT. News release. Cambridge Network. October 22, 2026. Accessed October 22, 2026. https://www.cambridgenetwork.co.uk/news/first-participants-join-major-uk-trial-test-alzheimers-treatments-cpft