UK Launches Ad-Smart Trial to Halve Time Needed to Test Alzheimer’s Treatments

Hundreds of people living with Alzheimer’s disease across Britain will be offered two existing medicines — a cheap diabetes pill and an established treatment for attention deficit hyperactivity disorder — as part of a ground-breaking clinical trial that its organisers say could more than halve the time it takes to discover new dementia treatments, according to reports in The Times and the Press Association.

The trial, named Ad-Smart, is being led jointly by the UK Dementia Research Institute (UKDRI) and the charity Alzheimer’s Research UK, with support from government funders. It will enrol more than 1,200 NHS patients aged over 55 with a diagnosis of Alzheimer’s or mixed dementia, testing several medicines in parallel against a shared placebo group rather than running a separate conventional trial for each candidate.

The first two drugs to go under the microscope are metformin, the widely used treatment for type 2 diabetes, and atomoxetine, a long-established medicine for ADHD. An international panel of experts selected both after evidence suggested they can reduce inflammation in the central nervous system — a driver of the neurodegeneration at the heart of Alzheimer’s — and researchers say atomoxetine may interfere with the processes that cause further decline, while metformin shows promise on several of the disease’s pathways, according to pharmaphorum.

Prime Minister Andy Burnham, whose father Roy died with Alzheimer’s in September, has thrown his personal weight behind the trial, declaring dementia research a national priority and saying he wants Britain to lead the world in the search for treatments.

“I know how it feels to lose a loved one to dementia and have seen first-hand the devastating impact this illness has on families,” Mr Burnham said, according to the Press Association. “That’s why I’m proud to see this trial being launched in the UK, so that cutting-edge treatments can reach patients here as soon as possible.”

Roy Burnham, a former telephone engineer, had been living in a care home at the time of his death. His illness meant he never knew his son had become Prime Minister, the Press Association reported.

How Ad-Smart works

Ad-Smart — short for Alzheimer’s disease Systematic Multi-arm Adaptive Randomised Trial — is what researchers call a platform trial. Instead of the traditional one-drug-one-trial model, which can take a decade or more to deliver a single verdict, it runs several treatment arms side by side under one shared structure.

Participants are divided into groups, each receiving a different medicine, with results compared against a single placebo group. Drugs that fail to show promise can be dropped quickly, and new candidates — including future medicines designed specifically for Alzheimer’s — can be slotted into the same trial without the long process of launching an entirely new study.

Experts behind the project say the approach has already proven itself in cancer research and in the fight against Covid-19, where platform trials identified effective medicines at a pace conventional designs could not match. Closer to home, a sister project — MND-Smart, testing repurposed therapies for motor neurone disease — has been running since 2020. It examined three candidates — amantadine, memantine and trazodone — and delivered verdicts on all three in just three years, a process that would have taken around eight years with traditional trial designs, according to the UK Dementia Research Institute. None of the three worked, but the adaptive design meant they were set aside rapidly and a fourth candidate, tacrolimus, was added without starting over.

The trial’s chief investigator, Professor Paresh Malhotra, group leader at the UK Dementia Research Institute Centre for Care Research & Technology at Imperial College London, said the old pace of research was no longer acceptable.

“For too long, Alzheimer’s research has moved at the pace of one drug, one trial, one answer — sometimes taking a decade or more before we know if we’ve found something that works,” he told the BBC, according to reports carried on Wednesday. “We are applying advances from cancer and other conditions to accelerate testing of treatments for people with Alzheimer’s 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,” he added, according to The Times.

Recruitment already under way

Recruitment has already begun at sites run by two NHS trusts — Cambridgeshire and Peterborough NHS Foundation Trust, and Surrey and Borders Partnership NHS Foundation Trust — with three more sites now open and a target of around 30 sites across the country over the next 18 months, including in London, Edinburgh and Southampton, according to pharmaphorum.

Around 1,200 participants will be needed to test the first two medicines, with the first conclusions expected in 2030. Additional therapies will be added into the trial in the intervening four-year period, meaning the trial’s verdicts will roll out in stages rather than all at once.

Participants will be assessed regularly through brain scans and blood tests, and the study will examine whether the repurposed medicines can lessen symptoms such as memory and cognitive impairment and help people maintain their quality of life as the disease progresses, according to reports.

Among the first to enrol is Heather Ransome, 67, from the Isle of Wight, who was diagnosed with Alzheimer’s in 2024.

“Before my diagnosis, my partner and I were going on lots of cruises and coach holidays, enjoying retirement together. We still enjoy life, but I’m worried about my condition getting worse,” she said, according to pharmaphorum. “There weren’t many treatment options available, and the one drug I was offered has been around for many years. Getting involved with Ad-Smart has given me some hope for the future.”

The trial’s launch comes weeks after the government announced it was putting £80 million behind nine new technologies aimed at diagnosing different forms of dementia more quickly, with a target of ensuring 92 per cent of people receive a diagnosis within 18 weeks of referral, according to pharmaphorum.

Analysis: Why It Matters

Old pills for a new problem — the logic of repurposing

The two drugs at the heart of Ad-Smart’s first phase are not new, and that is precisely the point. Metformin has been a first-line treatment for type 2 diabetes for decades; atomoxetine is a well-established ADHD medicine. Both are off-patent, cheap to manufacture and have safety profiles documented across millions of patient-years. If either were to show even a modest benefit in slowing Alzheimer’s, it could be prescribed on the NHS almost immediately — no years-long wait for manufacturing scale-up, no five-figure annual price tag per patient.

That stands in sharp contrast to the recent generation of Alzheimer’s drugs: the monoclonal antibodies targeting amyloid plaques, which have arrived with eye-watering costs, infusion infrastructure demands and debated benefit. Repurposing flips the economics of hope. The gamble is scientific rather than commercial — and the selection of these two candidates rests on a serious biological thread. Growing evidence has linked chronic inflammation in the central nervous system to the progression of neurodegeneration, and both drugs are thought to act on precisely those inflammatory pathways. If that hypothesis holds, the payoff could extend far beyond these two pills, pointing researchers toward a whole class of anti-inflammatory approaches.

The real breakthrough is the method, not the molecules

What makes Ad-Smart genuinely novel is not which pills it starts with but how it tests them. The conventional drug-development pipeline for dementia is brutally inefficient: years to design a trial, years to recruit, years to follow up — and if the answer is negative, you start again from zero. Platform trials collapse that cycle. They share infrastructure, share a control group and let scientists swap candidates in and out without rebuilding the machine.

Oncology adopted this discipline years ago — trials such as RECOVERY during the Covid pandemic showed how a shared-platform model could identify life-saving treatments in months. Neurology has lagged, partly because brain diseases are slower-moving and harder to measure. Ad-Smart imports the oncology playbook into dementia research, and if it works, its legacy may matter more than any single drug it tests. Every future Alzheimer’s candidate — including genuinely new molecules — could ride on the rails it lays. That is why researchers talk about halving development time rather than simply finding one treatment: the trial is infrastructure, not a single experiment.

Fast failure is a feature, not a flaw

The story of MND-Smart deserves to be read carefully. All three of its first candidates failed. In a conventional telling, that is a disappointment. In the platform-trial telling, it is a triumph: three clear, rigorous negative answers in three years instead of eight, freeing scientists and patients to move on to the next idea. Alzheimer’s research is littered with the opposite experience — decade-long trials that ended in crushing, expensive failure, consuming the best years of participants’ lives.

Ad-Smart’s design treats negative results as data rather than disaster. That cultural shift matters for dementia in particular, because the field has been haunted by a narrow obsession with amyloid plaques — a hypothesis that produced spectacular trial failures for years. A system that can test and discard ideas quickly is a system that can explore more of the hypothesis space: inflammation, metabolism, vascular health, immune response. Metformin, notably, is a metabolic drug; its selection reflects a growing willingness to ask whether Alzheimer’s is as much a disease of brain energy as of plaques.

A Prime Minister’s personal stake

Andy Burnham’s involvement is more than ceremonial. His father Roy died with Alzheimer’s in September, in a care home, never knowing his son had reached Downing Street — a private grief the Prime Minister has now made a matter of public policy, declaring dementia research a national priority. When a head of government says “I know how it feels,” it carries a different weight from the usual ribbon-cutting rhetoric.

That personal stake arrives at a moment when Britain’s dementia arithmetic is becoming impossible to ignore. An ageing population means the number of people living with dementia is projected to keep climbing for decades, with the care bill — social care, lost earnings for carers, NHS costs — already running into the tens of billions. A government searching for stories of renewal could do worse than back a trial that promises to make Britain “the leading nation” in breakthroughs, as Mr Burnham put it. But the test of his commitment will come in budgets and infrastructure, not quotes: trials like this need research nurses, scanning capacity and a diagnostics system that finds patients early enough for treatments to matter — which is precisely why the £80 million for faster diagnosis, announced earlier this month, is more than a footnote.

Diagnosis is the other half of the equation

Here is the quiet catch in the Ad-Smart story: treatments only help patients who are diagnosed. Britain’s dementia diagnosis rates remain patchy, with many people reaching a specialist only after years of symptoms. The government’s new target — 92 per cent diagnosed within 18 weeks of referral — is ambitious, and it is the essential twin of the treatment hunt. A breakthrough drug that arrives for patients nobody has found in time is a breakthrough wasted.

The two strands are finally moving together: the same month the state commits to finding dementia faster, it backs a machine to treat it faster. Whether that synchrony survives the fiscal pressures of the coming Budget — with public debt having just crossed £3 trillion and inflation back at 3.5 per cent — is one of the genuine unknowns. Research funding is easy to promise in a press release and easy to squeeze in a spending round. The trial’s 2030 horizon means it must survive at least one more Parliament’s priorities.

What to Watch Next

1. Recruitment pace: finding 1,200 participants with early-stage Alzheimer’s or mixed dementia across 30 NHS sites is itself a logistical test. Watch how quickly enrolment builds beyond the first five sites — it will signal whether Britain’s research-ready NHS capacity matches its ambition.
2. New arms, new hope: the trial’s design allows fresh drugs — including purpose-built Alzheimer’s molecules — to be added over the next four years. The first additions will show whether the platform model attracts the most exciting candidates, or settles for repurposing alone.
3. The 2030 readouts: four years feels distant, but in dementia research it is unusually soon. The first conclusions on metformin and atomoxetine will either hand the NHS two affordable options or demonstrate, at speed, that the field must look elsewhere.
4. The diagnosis race: the £80 million push to diagnose dementia within 18 weeks will determine whether treatments reach people in time to help. Track the 92 per cent target — it is the bottleneck the trial cannot fix alone.
5. The funding test: with the Chancellor’s Budget due on 28 October and borrowing under intense scrutiny, watch whether dementia research’s “national priority” status survives contact with fiscal reality — and whether Burnham’s personal commitment translates into sustained multi-year funding.

Sources

• The Times — “ADHD and diabetes drugs to be tested in Alzheimer’s clinical trial” (22 October 2026)
• Press Association via Pink Un — “New clinical trial backed by Andy Burnham could speed up Alzheimer’s treatments” (22 October 2026)
• pharmaphorum — “UK trial ‘could halve time to test Alzheimer’s drugs'” (22 October 2026)