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ALN-APP

Phase 2

Cerebral Amyloid Angiopathy | RNA therapy | Neurology |Alnylam Pharmaceuticals, Inc.|Trials Updated: Oct 13, 2026

ALN-APP development status

Highest phase Phase 2
Registered trials 3 across 1 sponsor since Feb 2022

ALN-APP target and mechanism

ModalityRNA therapy

Also known as mivelsiran

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials3
Total Enrollment328

FDA Designations

No designations recorded

ALN-APP clinical trials

ALN-APP · 3 trials · 3 indications

Phase 2 2Phase 1 1
NCT07636811A Study to Evaluate Mivelsiran in Adult Participants With Early-Stage Down Syndrome-Associated Alzheimer's Disease (DS-AD)Down Syndrome-Associated Alzheimer's Disease (DS-AD)
RECRUITING58 Analytics
NCT06393712A Phase 2 Trial of ALN-APP in Patients With Cerebral Amyloid AngiopathyCerebral Amyloid Angiopathy
ACTIVE NOT_RECRUITING210 Analytics
PHASE2RECRUITING
A Study to Evaluate Mivelsiran in Adult Participants With Early-Stage Down Syndrome-Associated Alzheimer's Disease (DS-AD)
Down Syndrome-Associated Alzheimer's Disease (DS-AD)Unlock trial analytics
PHASE2ACTIVE NOT_RECRUITING
A Phase 2 Trial of ALN-APP in Patients With Cerebral Amyloid Angiopathy
Cerebral Amyloid AngiopathyUnlock trial analytics

Study Endpoints

Primary Endpoints

Double-Blind Period: Change from baseline in brain amyloid burden measured in centiloids (CLs)
Up to 24 months
Double-blind Treatment Period: Annualized Rate of New Lobar Cerebral Microbleeds (CMBs) Assessed on Magnetic Resonance Imaging (MRI) of Brain in Patients with Sporadic Cerebral Amyloid Angiopathy (sCAA)
Up to 24 months
Part A: Frequency of Adverse Events
Up to 12 months
Part B: Frequency of Adverse Events
Up to 42 months

Secondary Endpoints

Double-Blind Period: Change from baseline in APP protein concentration in cerebrospinal fluid (CSF)
Up to 24 months
Double-Blind Period: Change from baseline in the concentration of amyloid beta proteins in CSF
Up to 24 months
Double-Blind Period: Change from baseline in the concentration of tau proteins in plasma
Up to 24 months
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Mivelsiran (Treatment Group A)EXPERIMENTALParticipants will be administered multiple low doses of mivelsiran.
Mivelsiran (Treatment Group B)EXPERIMENTALParticipants will be administered multiple high doses of mivelsiran.
Placebo (Treatment Group C)PLACEBO_COMPARATORParticipants will be administered multiple doses of placebo.
ALN-APPEXPERIMENTALParticipants will be administered multiple doses of ALN-APP during the double-blind treatment period and optional open-label extension period.
Placebo/ALN-APPPLACEBO_COMPARATORParticipants will be administered multiple doses of placebo during the double-blind treatment period. Participants who continue into the optional open-label extension period will be administered multiple doses of ALN-APP.
Part A: ALN-APPEXPERIMENTALParticipants will be administered a single dose of ALN-APP.
Part A: PlaceboPLACEBO_COMPARATORParticipants will be administered a single dose of placebo.
Part B:EXPERIMENTALParticipants will be administered multiple doses of ALN-APP.

Interventions

NameTypeDescription
MivelsiranDRUGMivelsiran will be administered intrathecally
PlaceboDRUGPlacebo will be administered intrathecally
ALN-APPDRUGALN-APP will be administered intrathecally
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Eligibility Criteria

Age Range40 Years to 55 Years
SexALL
Healthy VolunteersNo
Study Sites10

Inclusion Criteria: * Clinical diagnosis of Down-Syndrome (DS) associated with trisomy 21 * Positive amyloid PET scan * Cognitively stable in the opinion of the investigator * Seizures must be well controlled with no occurrence of seizures in the 6 months prior to screening Exclusion Criteria: * ...

Countries:United StatesSpainAustraliaCanadaNetherlandsSwitzerlandUnited Kingdom
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Recent Changes (Last 90 Days)

LOWOct 13, 2026NCT07636811Completion: 2031-07-23 → 2031-07-30
LOWOct 13, 2026NCT07636811Completion: 2031-07-23 → 2031-07-30
LOWSep 19, 2026NCT06393712lastUpdatePostDate: changed
LOWSep 19, 2026NCT06393712lastUpdatePostDate: changed
LOWSep 19, 2026NCT06393712lastUpdatePostDate: changed
LOWSep 15, 2026NCT05231785lastUpdatePostDate: changed
LOWSep 15, 2026NCT05231785lastUpdatePostDate: changed
LOWSep 15, 2026NCT05231785lastUpdatePostDate: changed
LOWSep 4, 2026NCT07636811startDate: changed
LOWSep 4, 2026NCT07636811startDate: changed
MEDIUMSep 3, 2026NCT06393712Status: RECRUITING → ACTIVE_NOT_RECRUITING
MEDIUMSep 3, 2026NCT06393712Status: RECRUITING → ACTIVE_NOT_RECRUITING
LOWAug 12, 2026NCT05231785lastUpdatePostDate: changed
LOWAug 12, 2026NCT07636811Status: NOT_YET_RECRUITING → RECRUITING
LOWAug 12, 2026NCT05231785lastUpdatePostDate: changed
LOWAug 12, 2026NCT07636811Status: NOT_YET_RECRUITING → RECRUITING

Frequently asked questions about ALN-APP

What is ALN-APP used for?

ALN-APP is an investigational RNA therapy being developed for cerebral amyloid angiopathy and early-onset Alzheimer disease. It is not approved for any indication and remains in clinical development. Alnylam Pharmaceuticals is evaluating it in a Phase 2 trial in cerebral amyloid angiopathy and a Phase 1 study in early-onset Alzheimer disease.

What does ALN-APP target?

ALN-APP is an RNA therapy designed to target amyloid precursor protein, or APP, production. By reducing APP synthesis, the therapy aims to lower amyloid beta accumulation associated with cerebral amyloid angiopathy and early-onset Alzheimer disease. It is administered as an investigational treatment and has not been approved by any regulatory agency.

Who is developing ALN-APP?

ALN-APP is being developed by Alnylam Pharmaceuticals, Inc., which trades on the Nasdaq under the ticker ALNY. The company is running clinical trials of ALN-APP in cerebral amyloid angiopathy and early-onset Alzheimer disease. Alnylam is a biopharmaceutical company focused on RNA interference therapeutics.

What phase is ALN-APP in?

ALN-APP is in Phase 2 clinical development. The Phase 2 trial is evaluating ALN-APP in patients with cerebral amyloid angiopathy. A separate Phase 1 study is evaluating the therapy in patients with early-onset Alzheimer disease. ALN-APP is investigational and has not received FDA approval.

What clinical trials is ALN-APP in?

ALN-APP is being studied in two clinical trials. NCT06393712 is a Phase 2 trial in patients with cerebral amyloid angiopathy, with 210 participants across the United States, Australia, Canada, Netherlands, Switzerland, and the United Kingdom. NCT05231785 is a Phase 1 study in early-onset Alzheimer disease, with 60 participants across the United States, Canada, Netherlands, and the United Kingdom.