New Alzheimer’s Prevention Drug Trials Begin in Colombia

Researchers in Colombia have initiated new clinical trials to test whether Alzheimer’s disease can be prevented in individuals with a genetic mutation that virtually guarantees early-onset dementia. The studies focus on members of the world’s largest autosomal dominant Alzheimer’s kindred in Antioquia, who carry the presenilin 1 (PSEN1) E280A mutation and typically develop cognitive impairment around age 44.

The trials build on the Alzheimer’s Prevention Initiative (API) Autosomal Dominant Alzheimer’s Disease (ADAD) Colombia Trial, which began in 2013 and is conducted by the University of Antioquia’s Neurosciences Group (GNA) in Medellín in collaboration with Banner Alzheimer’s Institute in Phoenix and Genentech. This long-standing infrastructure enables researchers to track biomarker changes and cognitive outcomes in mutation carriers years before symptoms appear.

One approach involves a dual-drug strategy combining donanemab, an amyloid-targeting antibody recently approved by the U.S. Food and Drug Administration for Alzheimer’s treatment, with RG6289, an investigational tau immunotherapy developed by Roche/Genentech. Scientists aim to remove existing amyloid plaques as completely as possible and then evaluate methods to prevent their recurrence and mitigate downstream disease processes such as tau tangles and neurodegeneration.

Scientists emphasize that the Colombian kindred offers a unique opportunity to study Alzheimer’s prevention because all carriers of the PSEN1 E280A mutation are expected to develop symptoms, allowing clear measurement of whether interventions delay or prevent onset. The trials are supported by funding from the National Institutes of Health, including a $74.5 million five-year grant awarded in November 2024 to Banner Alzheimer’s Institute and the University of Antioquia to expand prevention research in this population.

While the trials are ongoing, researchers caution that results will take years to determine, as prevention must be demonstrated over decades in this high-risk group. They note that success in this genetically defined population does not guarantee effectiveness in sporadic Alzheimer’s disease, which accounts for the majority of cases and involves more complex risk factors.