About AD SMART
A first-of-its-kind clinical trial in the UK, testing several possible treatments for Alzheimer's at the same time.
What is AD-SMART?
AD-SMART stands for Alzheimer's disease Systematic Multi-arm Adaptive Randomised Trial. It tests several possible treatments for Alzheimer's at the same time, each in a different group of people.
The trial is led by the UK Dementia Research Institute (UK DRI) and Alzheimer's Research UK, in partnership with Health Data Research UK, with support from the Medical Research Council (MRC) and the National Institute for Health and Care Research (NIHR).
The medicines being tested
The trial starts with two medicines that are already approved and used safely for other conditions. Because they are known to be safe, if either helps people with Alzheimer's it could reach them much faster than a brand-new medicine.
Metformin
Currently used for type 2 diabetes.
Atomoxetine
Currently used for ADHD.
These two were chosen by an international panel of experts, working alongside people with lived experience of Alzheimer's, based on evidence from earlier studies and laboratory research. AD-SMART is also designed to test new possible treatments as they come through the research pipeline.
How the trial works
AD-SMART is a multi-arm, multi-stage platform trial. In plain terms, that means:
- Several medicines are tested at the same time. Each has its own group of participants.
- Results are compared with one shared group taking a dummy medicine (placebo). More people receive an active medicine than in a usual trial.
- Results are checked at regular stages. A medicine that is not working can be dropped quickly, and a new one added.
Sharing one placebo group means the time it takes to test treatments can be more than halved compared with traditional trials, and costs come down too.
1,200
participants testing the first two medicines
30+
NHS sites planned
2030
first results published
“We already know this model works. The SMART approach has shown that testing multiple drugs at once, in one smart trial design, can speed up the testing of new treatments for neurodegenerative conditions. Now, we're doing the same for Alzheimer's.”
Prof Siddharthan Chandran, Director of the UK DRI
Where the trial is
The AD-SMART trial is currently being run from sites in Cambridge, Surrey, Edinburgh and Southampton, with many more planned to open across the UK over the next 12 to 18 months.
Funding partners
Delivered by the UCL Innovative Clinical Trials Unit
The trial is being delivered by a team at the Innovative Clinical Trials Unit and the MRC Centre of Research Excellence in Clinical Trial Innovation (UCL), Imperial College London and the University of Oxford, with support from leading Alzheimer's experts from across the UK.
Collaborators
AD-SMART brings together clinicians and researchers from across the UK.