New Alzheimer’s Trial Targets Disease Decades Before Symptoms Appear

What is going on

Alzheimer’s disease is primarily associated with the buildup of amyloid beta plaques in the brain, clumps of misfolded proteins that accumulate up to 25 years before symptoms arise. These plaques disrupt neuron function, leading to memory loss, cognitive decline, and eventually dementia.

Researchers are testing a potential preventive treatment for this process using a drug from Eli Lilly, a medicine, known as remternetug. This investigational antibody is designed to remove existing amyloid plaques or prevent their formation, potentially stopping Alzheimer’s before symptoms ever develop.

The trial

The Primary Prevention Trial, led by Washington University School of Medicine, is investigating whether remternetug can prevent Alzheimer’s disease in young adults carrying genetic mutations that all but guarantee early-onset Alzheimer’s.

Remternetug was chosen for this study because:

• In early trials with symptomatic patients, it has been shown to robustly remove amyloid plaques, comparable to donanemab, an FDA-approved Alzheimer’s therapy also developed by Eli Lilly.

• Unlike donanemab and other approved Alzheimer’s treatments, remternetug can be administered via a simple injection under the skin, rather than an IV infusion, making it faster and less invasive.

• Participants will receive remternetug or a placebo every 3 months, which is less frequent than the bi-weekly or monthly dosing required for current FDA-approved Alzheimer’s treatments.

• The study will help scientists determine the optimal dosing schedule for prevention and guide future Alzheimer’s prevention strategies.

There will be approximately 240 participants worldwide, including a control group of individuals without the genetic mutation for comparison. The study will last two years, during which researchers will monitor amyloid buildup using brain scans and analyze molecular markers of Alzheimer’s in blood and cerebrospinal fluid.

Why this matters

Previous Alzheimer’s treatments focused on managing symptoms, rather than stopping the disease at its root. Recent advances, including FDA-approved amyloid-targeting drugs, have shown that clearing amyloid plaques can slow disease progression.

This study takes it a step further and if successful, it could pave the way for preventing Alzheimer’s altogether, transforming the way the disease is treated.

“We have seen tremendous progress in the treatment of Alzheimer disease in the past few years,” said Eric McDade, professor of neurology at WashU Medicine and the trial’s principal investigator.

Final thoughts

This trial represents a shift from treatment to prevention, a core idea in longevity. If successful, it would be one of the strongest proofs that intervening decades before disease onset can delay or even prevent age-related decline. The implications extend far beyond Alzheimer’s, a positive outcome could accelerate investment and research into preventative longevity treatments, reinforcing the idea that aging itself is not an untouchable process.