Can a new drug stop Alzheimer's before it starts?
NCT ID NCT05552157
First seen Jun 25, 2026 · Last updated Jul 28, 2026 · Updated 3 times
Summary
This study tests whether the drug remternetug can prevent or slow the buildup of harmful proteins in the brains of people who have a genetic mutation that almost always causes early-onset Alzheimer's. About 280 participants will receive either the drug or a placebo every 12 weeks. The goal is to see if early treatment can stop the disease from progressing.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- remternetug
- What this could lead to
- If successful, this could show that early treatment can prevent or delay Alzheimer's symptoms in people who are genetically destined to develop the disease.
- What could go wrong
- This is an early-to-mid-stage trial with only 280 participants, so results may not apply to everyone. The drug may not slow the disease or could cause side effects like brain swelling.
This is an AI summary of the original study and may miss details. Read our disclaimer.
Study facts
What this study's own registry entry says, in plain language.
- Phase
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Phase 2/3
Runs two stages together: whether the treatment works, then large-scale confirmation.
- Participants
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About 280 people
The number the study aims to enrol. It can still change while the study runs.
- Started
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Nov 2024
- Expected to finish
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Aug 2034
An estimate. End dates often move.
- Lead sponsor
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Other sponsor
The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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18 years and older
- Sex
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Anyone
- Healthy volunteers
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Accepted
You do not need to have the condition being studied to take part.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: 1. Provide written informed consent, signed, and dated by the participant and study partner, or by the participant's legally authorized representative if applicable, according to local regulations for the ICF and, if applicable, country specific ICFs. 2. Participant is at least 18 years old. 3. People of childbearing potential 1. Must have a negative serum pregnancy test at screening (V1) 2. Must agree not to try to become pregnant from the time of signed ICF until twenty (20) weeks after the last dose of any study drug. 3. Must agree not to breastfeed from the time of signed ICF until twenty (20) weeks after the last dose of any study drug. 4. If partner is not sterilized, must agree to use highly effective contraceptive measures, methods that can achieve a failure rate of less than 1% per year when used consistently and correctly from screening (V1) until twenty (20) weeks after last dose of any study drug. i. combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation: oral, intravaginal, transdermal ii. progestogen-only hormonal contraception associated with inhibition of ovulation: oral, injectable, implantable iii. intra-uterine device (IUD) iv. intrauterine hormone-releasing systems (IUS) v. bilateral tubal occlusion vi. vasectomized partner (only when this is the only partner) vii. true sexual abstinence when this is in line with the preferred and usual lifestyle of the participant. (Periodic abstinence \[e.g., calendar, ovulation, symptothermal, post-ovulation methods\], declaration of abstinence for the duration of exposure to IMP, and withdrawal are not acceptable methods of contraception) 4. Mutation Status: 1. Participant is a carrier of a mutation in an APP, PSEN1, or PSEN2 gene that is associated with DIAD or does not know their mutation status and there is a mutation in their family pedigree that puts them at a direct risk of inheriting the known mutation; 2. Participant is -25 to -11 years from predicted age of cognitive symptom onset based on their mutation type or family pedigree Note: If the at-risk parent is deemed a non-carrier through confirmed genetic testing at any time during the study, the participant will be withdrawn. 5. Cognitive status of participant is normal (CDR-SB 0). 6. Fluency in DIAN-TU trial approved language and evidence of adequate premorbid intellectual functioning. Participants must be fluent in languages for which cognitive and clinical measures have been translated and validated for use in the DIAN-TU. Fluency is generally defined as daily or frequent functional use of a language generally from birth or a young age. In cultures where multiple languages are spoken or for participants who are multilingual, determination as to whether a participant's level of fluency in languages for which clinical and cognitive measures are available meets qualification for the study should be made by the site PI. 7. Adequate visual and auditory abilities to perform all aspects of the cognitive and clinical assessments. 8. Receiving stable doses of medication(s) for the treatment of non-excluded medical condition(s) for at least 30 days prior to baseline visit (V2) with the exceptions of medications taken for episodic conditions (e.g., migraine abortive therapy, antibiotics, and other medications for upper respiratory and gastrointestinal ailments). 9. Has a study partner who in the PI's judgment can provide accurate information as to the participant's cognitive and functional abilities, who agrees to provide information at the study visits that require study partner input for scale completion, and who signs the necessary ICF, if applicable. 10. Agrees not to donate blood or blood products for transfusion from the time of Screening (V1) for a study drug arm, for the duration of the study, and for 5 half lives after the final dose of study drug. 11. In the opinion of the PI, the participant will be compliant and have a high probability of completing the study. 12. Willing to complete all study-related testing, evaluations, and procedures. Exclusion Criteria: 1. Significant neurologic disease (other than AD) or psychiatric disease that may currently or during the study affect cognition or the participant's ability to complete the study. This would include disorders such as: recent or severe head trauma causing cognitive change, seizure disorder, neurodegenerative disease other than DIAD, hydrocephalus, cerebral/spinal hematoma, inflammatory disease, CNS infection (e.g., encephalitis or meningitis), neoplasm, toxic exposure, metabolic disorder (including hypoxic or hypoglycemic episodes) or endocrine disorder; psychiatric disorders such as schizophrenia, schizoaffective disorder, bipolar disorder or major depression, or any other psychiatric condition/disorder which could significantly interfere with the participant's cooperative participation (e.g., prominent anxiety, agitation or behavioral problems). Disorders that are controlled medically or remote history of these disorders (e.g., history of febrile seizures in childhood) that are not likely to interfere with cognitive function and compliance with study procedures are not exclusionary. 2. At high risk for suicide, e.g., significant suicidal ideation or attempt within last 12 months, current major depression (as defined in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition \[DSM-V\]), or increased suicide risk based on screening Columbia Suicide Severity Rating Scale (C-SSRS). Current stable mild depression or current use of antidepressant medications are not exclusionary. 3. History of clinically evident stroke or history of clinically important carotid or vertebrobasilar stenosis, plaque, or other prominent risk factor for stroke or cerebral hemorrhage (including atrial fibrillation and anticoagulation, documented transient ischemic attack \[TIA\] in the last 12 months) that may be interfering with cognition or is likely to impact with the participant's ability to complete the study. 4. Alcohol or substance use sufficient to meet DSM-V criteria currently or within the past year. 5. History of or Baseline (V2) visit brain MRI scan indicative of any other significant abnormality, definite microhemorrhages, evidence of a cerebral contusion, encephalomalacia, or aneurysms. Minor or clinically insignificant imaging findings are not exclusionary. 6. Presence of certain implanted medical devices, such as some pacemakers, aneurysm clips, artificial heart valves, ear implants, or foreign metal objects in the eyes, skin, or body which would preclude MRI scan. 7. Cardiovascular complications such as uncontrolled hypertension, history of myocardial infarcts, heart failure, atrial fibrillation, long QT interval on ECG likely to interfere with participation in or analysis of the trial in the opinion of the investigator 8. Hepatic or renal abnormalities that in the opinion of the investigator would interfere with participation in or analysis of the trial. 9. History of Human Immunodeficiency Virus (HIV) infection, history of Hepatitis B infection within the past year, history of Hepatitis C infection which has not been adequately treated, history of spirochete infection (e.g., syphilis, Lyme) of the CNS or history of other infection with high risk for interfering with participation or interpretation of the study in the opinion of the investigator. 10. History of clinically significant multiple or severe drug allergies, significant atopy, or severe post-treatment hypersensitivity reactions (including but not limited to erythema multiforme major, linear IgA dermatosis, toxic epidermal necrolysis, and/or exfoliative dermatitis) or sensitivity to study-drug specific PET imaging agents with a high risk for interfering with participation or interpretation of the study in the opinion of the investigator. 11. Treatment with immunosuppressive medications (e.g., systemic corticosteroids) within 90 days prior to Baseline (V2) visit (topical and nasal corticosteroids and inhaled corticosteroids for asthma are permitted) or chemotherapeutic agents for malignancy within the last 3 years. 12. Current clinically significant abnormalities of thyroid function, or clinically significant deficiency in vitamin B12. Vitamin B12 less than the lower limits of normal with normal methylmalonic acid (MMA)/homocysteine is not deemed clinically significant, therefore not exclusionary. 13. Unstable or poorly controlled diabetes which the investigator believes may interfere with participation in or analysis of the study protocol. Participants may be rescreened after 3 months to allow optimization of diabetic control 14. Morbid obesity with significant comorbidities or that would preclude MRI imaging. 15. Current use of anticoagulants (e.g., warfarin, dabigatran, rivaroxaban, or apixaban). Daily use of low dose (\< 325 mg) aspirin is not exclusionary. 16. Have been exposed to a monoclonal antibody targeting Aβ peptide within the past 6 months or 5 half-lives from screening, whichever is longer. 17. Received any other investigational pharmacological treatment within 3 months of Screening or 5 half-lives, whichever is longer. Note: Use of approved treatments for AD and other medications may be permitted in this study. 18. Lack of sufficient venous access. 19. Clinically relevant abnormalities in hematology, coagulation, or clinical chemistry. 20. History of cancer that the investigator believes has high risk of recurrence and impacting study participation or analysis. 21. Any other medical condition that could be expected to progress, recur, or change to such an extent that it could bias the assessment of the clinical or mental status of the participant to a significant degree or put the participant at special risk. 22. Currently, or within the last month prior to screening, participated in a clinical study, including a nonpharmacological study, without prior approval. 23. Participants with the "Dutch" APP E693Q mutation. 24. Unable to complete baseline visit (V2) procedures with appropriate cognitive and clinical scores for eligibility
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
How to take part
Only the study team decides who joins. These are the ways to reach them.
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The places running it
37 sites in 15 countries. The list below names each one and where it is.
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The official record
ClinicalTrials.gov lists the study team's own contact details, including names and phone numbers. We don't republish those.
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A doctor treating you
A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.
Contacts and locations
Locations
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Advocate Lutheran General Hospital
RECRUITINGPark Ridge, Illinois, 60068, United States
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Alzheimer's Research Australia
RECRUITINGMelbourne, Victoria, 3010, Australia
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Asan Medical Center
NOT_YET_RECRUITINGSeoul, South Korea
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Azienda Ospedaliera Universitaria Careggi
NOT_YET_RECRUITINGFlorence, 50134, Italy
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Brain Research Center
NOT_YET_RECRUITINGAmsterdam, 1081 GM, Netherlands
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Butler Hospital
RECRUITINGProvidence, Rhode Island, 02096, United States
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CHU de Quebec - Hôpital de l' Enfant Jésus
RECRUITINGQuébec, G1J 1Z4, Canada
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CHU de Rouen - Hôpital Charles Nicolle
NOT_YET_RECRUITINGRouen, Seine Maritime, 76031, France
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CHU de Toulouse - Hôpital Purpan
NOT_YET_RECRUITINGToulouse, Haute Garonne, 31059, France
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Emory University
RECRUITINGAtlanta, Georgia, 30329, United States
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Groupe Hospitalier Pitie-Salpetriere
NOT_YET_RECRUITINGParis, Paris, 69677, France
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Grupo de Neurociencias Sede de la Universidad de Antioquia
RECRUITINGMedellín, Colombia
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Hopital Neurologique Pierre Wertheimer
NOT_YET_RECRUITINGBron, Rhone, 69677, France
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Hopital Roger Salengro - CHU Lille
NOT_YET_RECRUITINGLille, Nord, 59037, France
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Hospital Clínic I Provincial de Barcelona
RECRUITINGBarcelona, 8036, Spain
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IRCCS Centro San Giovanni di Dio Fatebenefratelli
NOT_YET_RECRUITINGBrescia, 25125, Italy
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Indiana University School of Medicine
RECRUITINGIndianapolis, Indiana, 46202, United States
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Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez
NOT_YET_RECRUITINGMexico City, Mexico City, 14269, Mexico
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Instituto de Investigaciones Neurologicas Raul Carrea, FLENI
RECRUITINGCiudad Autonoma de Buenos Aire, C1428AQK, Argentina
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Kerwin Research and Memory Center
RECRUITINGDallas, Texas, 75231, United States
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LMU-Campus Grosshadern
NOT_YET_RECRUITINGMunich, Bavaria, 81377, Germany
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McGill Center for Studies in Aging
RECRUITINGVerdun, Quebec, H4H 1R3, Canada
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Neuroscience Research Australia
RECRUITINGRandwick, New South Wales, 2031, Australia
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New York University Medical Center
RECRUITINGNew York, New York, 10016, United States
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New Zealand Brain Research Institute
NOT_YET_RECRUITINGChristchurch, 8011, New Zealand
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Sunnybrook Health Sciences Centre
RECRUITINGToronto, Ontario, M4N 3M5, Canada
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The National Hospital for Neurology and Neurosurgery
RECRUITINGLondon, Greater London, WC1B 3BG, United Kingdom
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UBC Hospital
RECRUITINGVancouver, British Columbia, V6T 2B5, Canada
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Universitaetsklinikum Tubingen
RECRUITINGTübingen, Baden-Wurttemberg, 72076, Germany
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University of Alabama in Birmingham
RECRUITINGBirmingham, Alabama, 35294, United States
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University of California San Diego Medical Center
RECRUITINGLa Jolla, California, 92037, United States
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University of Pittsburgh
RECRUITINGPittsburgh, Pennsylvania, 15213, United States
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University of Puerto Rico, School of Medicine
RECRUITINGSan Juan, 00936, Puerto Rico
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University of Southern Califonria
NOT_YET_RECRUITINGLos Angeles, California, 90089, United States
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University of Washington
RECRUITINGSeattle, Washington, 98195, United States
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Washington University in St. Louis
RECRUITINGSt Louis, Missouri, 63110, United States
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Yale University School of Medicine
RECRUITINGNew Haven, Connecticut, 06510, United States
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