In results published Thursday in The Lancet, a team at University College London's Institute of Neurology revealed that their experimental compound, designated BR-7, produced statistically significant reductions in amyloid plaque accumulation across all age groups studied, with patients in the early-to-moderate stage of Alzheimer's disease showing the greatest benefit.

The trial, conducted across 31 NHS and private hospitals between 2023 and 2026, enrolled 4,200 participants with confirmed Alzheimer's diagnoses. Half received BR-7 via fortnightly intravenous infusion; the remainder received a placebo. At 36 months, those on the active treatment showed a 34% slower decline on the standardised cognitive battery used to measure the disease's progression.

"We are not talking about a cure. We are talking about something real, measurable and — if replicated — practice-changing." — Professor Diana Afolabi, lead researcher, UCL Institute of Neurology

How BR-7 works

Alzheimer's disease is characterised by the accumulation of amyloid-beta plaques between neurons and tau protein tangles within them. Most previous drug development has focused on clearing existing plaques — an approach that achieved only modest results in late-stage disease. BR-7 takes a different route: it targets a protein called TREM2, which regulates the brain's microglial immune cells. By enhancing TREM2 activity, the compound appears to sharpen the brain's own capacity to clear amyloid debris before it consolidates into plaques.

Secondary endpoints in the trial, including brain volume loss measured by MRI and caregiver-reported functional assessments, also favoured the treatment group, though the differences were less pronounced than the primary cognitive outcome.

What happens next

The Medicines and Healthcare products Regulatory Agency (MHRA) confirmed on Thursday that it has fast-tracked a licensing review for BR-7, citing the trial's scale and rigour. An approval decision is expected by the end of 2026. The National Institute for Health and Care Excellence (NICE) would then assess the drug's cost-effectiveness before recommending whether it should be funded by the NHS.

That final step is where optimism tends to stall. Lecanemab, a similar drug approved in the United States in 2023, was not recommended for routine NHS use due to a cost-per-quality-adjusted-life-year calculation that exceeded NICE thresholds. UCL has indicated that UCB Pharma, which holds the commercial licence for BR-7, is in early talks with the government over pricing.

With nearly one million people in the UK living with dementia and projections suggesting that figure will exceed 1.4 million by 2040, the pressure to find a pathway to NHS access is significant. Health Secretary Bridget Crane issued a statement calling the trial results "a hopeful landmark" and said she had requested an urgent briefing from NICE on timelines.

Independent experts were cautiously encouraging. Dr Malcolm Howarth of the Alzheimer's Society said the results were "genuinely impressive" but urged patience. "Phase III is not phase four," he said. "We now need peer review, regulatory scrutiny and real-world evidence. The history of Alzheimer's drug development is full of promising moments that did not survive contact with the wider population."