Trontinemab Clears Brain Amyloid in 90 Percent of Patients Within Six Months

Trontinemab reduced brain amyloid to normal levels in around 90 percent of participants with mild cognitive impairment or mild-to-moderate Alzheimer’s disease within six months of monthly dosing. @NewScientist reported the findings from a Roche trial presented at the Alzheimer’s Association International Conference in London on 14 July.

The drug binds to an iron-transport receptor to cross the blood-brain barrier.

This mechanism allowed lower doses than those required for lecanemab and donanemab, which rely on diffusion. Less than 5 percent of participants developed amyloid-related imaging abnormalities. Approved antibody drugs lecanemab and donanemab produce ARIAs in around 20 percent and 40 percent of patients, respectively.

Trontinemab achieved its amyloid reductions more quickly than either therapy, with levels remaining low for at least a year. Nick Fox at University College London said the reduction in amyloid was remarkable and achieved massive reductions quicker than seen before. He added that fewer infusions and fewer brain scans to monitor for ARIAs could further reduce costs.

Roche is planning two larger trials to assess whether trontinemab slows cognitive decline in early-stage Alzheimer’s disease and prevents the condition in at-risk people. Lecanemab and donanemab remain unavailable on the UK’s national health services due to modest effects and high prices.