To gather insights from global Alzheimer’s disease (AD) community representatives to help customize clinical trial design to improve participant experience.

Recruiting cognitively unimpaired amyloid-positive older adults at risk for progression due to AD is challenging. Understanding their needs, concerns, and motivations for trial participation could help optimize participant identification and engagement and determine mechanisms to improve trial experience and retention. Actioning feedback from the target population during protocol development could make the trial more accessible and sensitive to a broad variety of participants, making recruitment easier and aiding retention by establishing a positive trial experience. 

Advisory boards were held with two groups including CareRing; five Roche employees caring for people with AD, and representatives from twelve global AD advocacy organizations with diverse backgrounds, from multiple countries. Feedback was gathered on perceptions of the draft protocol design for SKYLINE, a global Phase III, multicenter study that was designed to evaluate the efficacy and safety of gantenerumab in participants at risk for or in the earliest stages of AD but stopped early (NCT05256134). Feedback received was incorporated into the SKYLINE protocol design.

Feedback highlighted the importance of three key areas to consider when conducting clinical trials in this population: 1. the importance of tailoring study materials and design to engage with a cognitively unimpaired, at-risk, or asymptomatic AD population and study partners, e.g., materials detailing trial expectations and home administration requirements;  2. flexibility of dosing options;  3. a sensitive and supportive disclosure process for brain amyloid status and apolipoprotein E genotype, along with guidance and training for site staff to ensure suitable support measures are available.