Alzheimer's disease drug development pipeline: 2023

INTRODUCTION: Drugs that prevent the onset, slow progression, or improve cognitive and behavioral symptoms of Alzheimer's disease (AD) are needed. METHODS: We searched ClinicalTrials.gov for all current Phase 1, 2 and 3 clinical trials for AD and mild cognitive impairment (MCI) attributed to AD. We created an automated computational database platform to search, archive, organize, and analyze the derived data. The Common Alzheimer's Disease Research Ontology (CADRO) was used to identify treatment targets and drug mechanisms. RESULTS: On the index date of January 1, 2023, there were 187 trials assessing 141 unique treatments for AD. Phase 3 included 36 agents in 55 trials; 87 agents were in 99 Phase 2 trials; and Phase 1 had 31 agents in 33 trials. Disease‐modifying therapies were the most common drugs comprising 79% of drugs in trials. Twenty‐eight percent of candidate therapies are repurposed agents. Populating all current Phase 1, 2, and 3 trials will require 57,465 participants. DISCUSSION: The AD drug development pipeline is advancing agents directed at a variety of target processes. HIGHLIGHTS: There are currently 187 trials assessing 141 drugs for the treatment of Alzheimer's disease (AD). Drugs in the AD pipeline address a variety of pathological processes. More than 57,000 participants will be required to populate all currently registered trials.