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New trial could more than halve the time it takes to test Alzheimer’s treatments

22 Oct 2026

A first-of-its-kind clinical trial run by Innovative Clinical Trials Unit aims to cut years from the search for treatments that work for people with Alzheimer’s disease.

The national trial, called AD- SMART (Alzheimer’s disease Systematic Multi-arm Adaptive Randomised Trial), will test multiple drugs simultaneously, starting with two repurposed medicines already used to treat type 2 diabetes and attention deficit hyperactivity disorder (ADHD). Groups of participants will each begin treatment with a different drug.

The study will examine whether these medicines can lessen symptoms such as memory and thinking problems, and help people maintain their quality-of-life as the disease progresses.

Testing drugs that are already approved to treat other conditions and known to be safe means that, if successful, treatments can reach people living with Alzheimer’s much faster than a medicine developed from scratch.

As well as repurposed drugs, the trial is designed to test new potential treatments coming through the research pipeline.

AD-SMART is a type of trial known as a multi-arm, multi-stage platform trial. Several drugs are tested at the same time, and the results compared with one group of participants taking a dummy drug (placebo). This means more people receive an active treatment than would in a traditional trial.

Results are checked at regular stages throughout the trial and any drug that isn’t showing benefit can be dropped quickly, with new drugs added in its place. Overall, this means fewer participants end up receiving ineffective drugs.

Testing several drugs against one shared placebo group means that ̶̶̶compared with a traditional trial, the time to evaluate treatments can be more than halved, which also reduces costs.

The trial is led by the UK Dementia Research Institute (UK DRI) and Alzheimer’s Research UK (ARUK) – in partnership with the National Institute for Health and Care Research (NIHR), the Medical Research Council (MRC) and Health Data Research UK (HDR UK), with ongoing funding committed by UK government.

The trial is being delivered by a team at the UCL Innovative Clinical Trials Unit and the MRC Centre of Research Excellence in Clinical Trial Innovation (a centre based at UCL whose leadership spans several universities), alongside Imperial College London, the University of Oxford and Dementias Platform UK (DPUK).

Alzheimer’s is the most common type of dementia, affecting around 600,000 people in the UK. There are currently no NHS treatments that can slow or stop the underlying disease.

The first trial participants have been recruited at Cambridgeshire and Peterborough NHS Foundation Trust and Surrey and Borders Partnership NHS Foundation Trust, and sites in West London, Edinburgh and Southampton are now open.

Up to 20 NHS sites are expected to open across the UK over the next 12-18 months and more than 30 are planned overall. Researchers aim to recruit 1,200 participants across the UK to test these first two drugs. They expect to finish evaluating the first drugs in 2030, in around four years’ time. During this initial four-year period, the team expect additional drugs to be added into the trial for testing.

AD-SMART is the first trial of this kind for people living with Alzheimer's, but the model, pioneered by researchers at the UCL Institute of Clinical Trials and Methodology, has already proven itself in the UK, with successful trials in prostate cancer, COVID-19 and motor neuron disease.

The two starting drugs were carefully chosen by an international panel of experts, together with people with lived experience of Alzheimer’s, based on evidence from earlier stage studies in patients as well as laboratory research.

People with a confirmed Alzheimer’s diagnosis who would like to take part can register their interest by:

Further information: