Roche Presents Trontinemab Data Showing Faster Amyloid Clearance With Fewer ARIAs

Roche presented data on its antibody drug trontinemab showing it cleared beta-amyloid from the brain faster than approved treatments while producing amyloid-related imaging abnormalities in fewer than 5 percent of participants. Luka Kulic at Roche in Basel, Switzerland, and colleagues shared the findings at the Alzheimer’s Association International Conference in London on 14 July.

Trontinemab binds to a receptor that transports iron across the blood-brain barrier, allowing more efficient entry into the brain than lecanemab or donanemab.

This mechanism permits lower doses. Last year, 90 percent of participants with mild cognitive impairment or mild-to-moderate Alzheimer’s disease reached normal brain amyloid levels within six months of monthly infusions, with reductions maintained for at least one year.

Approved antibody drugs lecanemab and donanemab, the first therapies cleared to slow Alzheimer’s progression in the US and UK, produced ARIAs in 20 percent and 40 percent of trial participants respectively.

Several deaths linked to ARIAs occurred in those trials. Luciana Maffei at the University of Oxford said the lower dose requirement makes trontinemab less disruptive to the brain. Nick Fox at University College London noted that the rapid amyloid reduction suggests trontinemab could match or exceed the clinical benefit of existing therapies.

Trontinemab is given as a monthly infusion. Roche is planning two larger trials to determine whether the drug slows cognitive decline in early-stage Alzheimer’s disease and prevents the condition in high-risk individuals.