EPAD - European Prevention of Alzheimer's Dementia Consortium

Given the evidence that Alzheimer's disease produces alterations in the brain prior to the onset of symptoms, the EPAD (European Prevention of Alzheimer's Dementia Consortium) project focuses on the initial stages of the disease in order to develop actions that may prevent and treat this type of dementia. In recent years, research has increasingly focused on this presymptomatic phase in order to offer new preventive treatments and operate more effectively.

The EPAD project, which started in 2015, is the largest public-private consortium in the field of Alzheimer's research thanks to the cooperation of 39 entities (research centers, universities, pharmaceutical laboratories and patient associations across Europe) and more than 1,500 registered participants. The consortium is funded by the grant number 115736 of the Innovative Medicines Initiative, which is a joint initiative of the research and innovation program Horizon 2020 of the European Commission and the European Federation of Pharmaceutical Industries and Associations (EFPIA).

Fundació ACE is the 32nd member of the group, having joined the consortium in 2019. and one of the representatives of the Spanish State, altogether with Fundació Pasqual Maragall research center, the Barcelonaβeta Brain Research Center, the Hospital Clínic de Barcelona and the Fundación CITA Alzheimer (San Sebastián).
 

The EPAD challenge

To carry out its goals, the EPAD project faces several challenges such as the difficulty of identifying people who may end up developing Alzheimer's disease, the lack of understanding of the earliest stages of the disease or poor flexibility in the development of clinical trials

To cope with these difficulties, three basic strategies have been developed from the consortium:

1. The registry:

EPAD aims to create the first single and pan-European registry of people who are at different risk of developing this dementia.

2. The cohort:

From this registry, research participants are invited to join a cohort of subjects at various levels of risk. Currently, more than 1,500 participants coming from centres across Europe are part of this cohort. They are carried out standardized tests and are followed for several years.

3. The test:

EPAD selects participants for adaptive clinical trials of drugs designed to prevent dementia. In fact, EPAD is a pioneer platform in the implementation of this method. While in traditional clinical trials, half of the participants receive the treatment under study, and half receive a placebo, in adaptive trials, several candidate drugs are compared simultaneously with each other, while also introducing a placebo.
 

As a consequence, a greater proportion of people will benefit from a potentially active treatment to reduce their risk of developing Alzheimer's in the future. In addition, researchers can adapt the design of the trials in response to emerging results, being able to add new candidate drugs and reduce those that are ineffective. With better data and better decision making, adaptive trials can increase the likelihood of success and decrease the duration of development.