Drug | Class | Primary clinical use | Trials underway to evaluate the use to treat or prevent dementia or cognitive decline | Putative primary mechanism of action | Estimated completion |
---|---|---|---|---|---|
Nilvadipine | Calcium channel blocker | Hypertension | NILVAD Phase III trial evaluating if this calcium-channel blocker can improve cognitive function in mild-moderate Alzheimer’s disease (NCT02017340) | Beta-amyloid clearance and cortical perfusion | 2017 |
Telmisartan versus Perindopril | ARB versus ACE inhibitor | Hypertension | SARTAN-AD Phase II head-to-head comparison of perindopril and telmisartan in Alzheimer’s patients with hypertension, using brain atrophy as an experimental surrogate marker (NCT02085265) | Beta-amyloid production and catabolism | 2017 |
Candesartan or Losartan | ARB | Hypertension | A Phase II trial with candesartan in MCI (NCT02646982) and Losartan in Alzheimer’s (ISRCTN93682878) | Neurovascular injury, blood-flow, beta-amyloid pathways | 2021 & 2017 |
Metformin | Biguanide | Diabetes | A Phase II in Alzheimer’s (NCT02409238) and a Phase II trial in MCI (NCT01965756) are underway | Restore insulin signaling in the brain | 2017 & 2016 |
Pioglitazone, mini-dose | Thiazolidinedione | Diabetes but at a different dose | Phase 3 trial testing a very low-dose formulation of pioglitazone to reduce the risk MCI due to Alzheimer’s (NCT01931566) | Metabolism and inflammation | 2019 |
Liraglutide | Incretin mimetic (GLP-1 agonist) | Diabetes | Two Phase II trials underway or recently completed in Alzheimer’s (NCT01843075; NCT01469351). A third trial is underway in aging adults at high risk of dementia (NCT02140983) and a fourth Phase III trial is underway on cognitive dysfunction in major depressive disorder or bipolar disorder (NCT02423824) | Restore insulin signaling in the brain to slow Alzheimer’s pathology | 2015–2017 |
Exenatide (Exendin-4) | Incretin mimetic (GLP-1 agonist) | Diabetes | A Phase 2 safety trial in patients with Alzheimer’s or mild cognitive impairment with secondary outcomes of behavioral and cognitive performance, ADAS-cog and CDR, and biomarkers related to Alzheimer’s disease and dementia (NCT01255163) | Restore insulin signaling in the brain to slow Alzheimer’s pathology | 2018 |