Middle-aged people without memory problems will be prescribed an Alzheimer’s drug in a study aimed at preventing dementia.
The first participants in Europe will be screened in Britain from Monday, with more than 15 British centers expected to take part in the global trial.
Previous research in patients with Alzheimer’s disease suggested that the treatment could remove toxic brain plaques after just three monthly infusions.
Now scientists will test whether giving the drug, called trontinemab, before symptoms appear can stop the development of Alzheimer’s in the first place.
If it proves successful, it has the potential to transform the way the disease is treated.
Ultimately, people at high risk in middle age could be prescribed preventive drugs, in a way that experts have likened to “statins for the brain.”
The launch comes as the Daily Mail and the Alzheimer’s Society team up in a drive to beat dementia, which claims 76,000 lives a year as Britain’s biggest killer.
The Defeating Dementia campaign aims to raise awareness of the disease, in an effort to increase early diagnosis, stimulate research and improve care.
Previous research in patients with Alzheimer’s disease suggested that the treatment could remove toxic brain plaques after just three monthly infusions.
Professor Ramin Nilforooshan, lead researcher on the PrevenTron study, said the study marked a fundamental shift from waiting for memory problems to develop to trying to prevent them in the first place.
He said: ‘For decades, research has focused on treating Alzheimer’s disease after symptoms have emerged.
‘PrevenTron focuses on a different question: whether we can act earlier, before symptoms start.’
Surrey and Borders Partnership NHS Foundation Trust is the first site in Europe and the third in the world to open the trial and will lead recruitment in Britain.
More than 15 UK hospitals and clinics are expected to participate.
The trial, which will last four to six years, will recruit approximately 1,600 healthy adults aged 55 to 80 internationally.
Professor Nilforooshan said Alzheimer’s pathology likely began five to 10 years before people typically sought treatment for memory problems.
Potential participants first undergo memory tests to determine that they have no significant cognitive problems.
They will then undergo a blood test that measures p-tau217, a protein that can reveal biological signs of Alzheimer’s disease before symptoms appear.
Those whose levels are elevated and within the range required by the trial will undergo further testing, including MRI and PET scans, before being enrolled.
Participants will be randomly assigned to treatment with trontinemab or a placebo, with researchers following them for four to six years to discover whether the drug can prevent or delay memory and thinking problems.
Professor Nilforooshan told the Telegraph: ‘I’m not saying this process is magical. It is an investigational drug. We have to wait and see: will it work or not?’
Trontinemab, developed by Swiss pharmaceutical company Roche, is designed to enter the brain more efficiently than existing Alzheimer’s disease drugs.
The drug attacks amyloid, the sticky protein that builds up in the brain and has been linked to the development of Alzheimer’s disease.
Clearance appears significantly faster than lecanemab and donanemab, the first drugs proven to slow the progression of Alzheimer’s disease, which typically takes more than a year to clear comparable levels of amyloid.
Studies of lecanemab and donanemab found that the drugs slowed cognitive decline by 27 percent and 35 percent, respectively, in patients who already had symptoms.
Both are licensed in Britain but have been rejected for routine NHS use after officials ruled they were not cost-effective.
Researchers will initially approach people who previously attended a memory clinic but were discharged after tests showed their memories were intact.
People can also contact the Surrey research team directly, with participants accepted from across the country.
Nearly a million people in Britain suffer from dementia, with a total forecast of 1.4 million by 2040.
