A clinical trial launched in the UK is testing repurposed diabetes and ADHD drugs on Alzheimer's patients in an effort to accelerate treatment discovery. The study, called AD-SMART, is evaluating metformin (used for type 2 diabetes) and atomoxetine (for ADHD) as potential therapies that may reduce brain inflammation, a driver of neurodegeneration.
Angela Bucksey, 67, from Cambridgeshire, became the first participant after receiving an Alzheimer's diagnosis in January. The trial uses a multi-arm, multi-stage platform approach, testing multiple drugs simultaneously against a placebo group. This structure allows researchers to drop ineffective treatments quickly and add new ones, an approach previously used successfully in cancer and motor neurone disease research.
The study will recruit 1,200 participants with mild to moderate Alzheimer's across more than 30 UK sites, including locations in Cambridgeshire, Surrey, London, Southampton, and Edinburgh. Participants will undergo regular cognitive testing and health checks to measure treatment effectiveness. Prof Paresh Malhotra, chief investigator at Imperial College London's UK Dementia Research Institute Centre, told the BBC that traditional Alzheimer's research "sometimes [takes] a decade or more before we know if we've found something that works." The new approach aims to compress that timeline.
Both initial drugs were selected by an international expert panel. For a drug to be considered successful, it must show beneficial effects on thinking and everyday functioning, not just biological markers. Scientists expect to finish evaluating the first drugs by 2030, with additional treatments likely added during the study.
Alzheimer's affects approximately 600,000 people in the UK. Prime Minister Andy Burnham, whose father died from Alzheimer's last month, stated he was proud to see the trial launched so "cutting-edge treatments can reach patients here as soon as possible."
The trial is led by the UK Dementia Research Institute and Alzheimer's Research UK, with funding from the UK government and partners including the National Institute for Health and Care Research and the Medical Research Council.