The 2024 Alzheimer's disease drug development pipeline includes 164 clinical trials assessing 127 drugs. This represents a decrease compared to the 2023 pipeline, which had 187 trials and 141 drugs. The number of new chemical entities (NCEs) has also decreased, from 101 in 2023 to 88 in 2024, a 13% drop. The pipeline includes a wide range of therapeutic targets, with the most common processes targeted including neurotransmitter receptors, inflammation, amyloid, and synaptic plasticity. The total development time for a potential Alzheimer's disease therapy to progress from nonclinical studies to FDA review is approximately 13 years. There are 48 Phase 3 trials testing 32 drugs, 90 Phase 2 trials assessing 81 drugs, and 26 Phase 1 trials testing 25 agents. Of the 164 trials, 34% assess disease-modifying biological agents, 41% test disease-modifying small molecule drugs, 10% evaluate cognitive enhancing agents, and 14% test drugs for the treatment of neuropsychiatric symptoms. The pipeline includes 39 repurposed agents, which account for 31% of current drugs and 32% of current trials. The pharmaceutical industry accounts for funding of 60% of trials. The majority of drugs in the pipeline are disease-modifying therapies (DMTs), with 96 DMTs representing 76% of drugs in clinical trials. DMTs are divided into biologics (e.g., monoclonal antibodies, vaccines, antisense oligonucleotides) and small molecules. Repurposed agents are more likely to be funded by non-industry sources and are less likely to advance to Phase 3. The pipeline includes a variety of combination therapies, including pharmacodynamic and pharmacokinetic combinations, as well as combinations aimed at enhancing penetration of the blood-brain barrier. The approval of lecanemab and the possible approval of donanemab may affect recruitment if patients choose approved over experimental therapies. The development of new therapies for Alzheimer's disease has made significant progress, with the approval of aducanumab in 2021 and lecanemab in 2023. The pipeline also includes agents targeting neuropsychiatric symptoms, with 31% of current drugs being repurposed agents. The total development time for a potential Alzheimer's disease therapy to progress from nonclinical studies to FDA review is approximately 13 years.The 2024 Alzheimer's disease drug development pipeline includes 164 clinical trials assessing 127 drugs. This represents a decrease compared to the 2023 pipeline, which had 187 trials and 141 drugs. The number of new chemical entities (NCEs) has also decreased, from 101 in 2023 to 88 in 2024, a 13% drop. The pipeline includes a wide range of therapeutic targets, with the most common processes targeted including neurotransmitter receptors, inflammation, amyloid, and synaptic plasticity. The total development time for a potential Alzheimer's disease therapy to progress from nonclinical studies to FDA review is approximately 13 years. There are 48 Phase 3 trials testing 32 drugs, 90 Phase 2 trials assessing 81 drugs, and 26 Phase 1 trials testing 25 agents. Of the 164 trials, 34% assess disease-modifying biological agents, 41% test disease-modifying small molecule drugs, 10% evaluate cognitive enhancing agents, and 14% test drugs for the treatment of neuropsychiatric symptoms. The pipeline includes 39 repurposed agents, which account for 31% of current drugs and 32% of current trials. The pharmaceutical industry accounts for funding of 60% of trials. The majority of drugs in the pipeline are disease-modifying therapies (DMTs), with 96 DMTs representing 76% of drugs in clinical trials. DMTs are divided into biologics (e.g., monoclonal antibodies, vaccines, antisense oligonucleotides) and small molecules. Repurposed agents are more likely to be funded by non-industry sources and are less likely to advance to Phase 3. The pipeline includes a variety of combination therapies, including pharmacodynamic and pharmacokinetic combinations, as well as combinations aimed at enhancing penetration of the blood-brain barrier. The approval of lecanemab and the possible approval of donanemab may affect recruitment if patients choose approved over experimental therapies. The development of new therapies for Alzheimer's disease has made significant progress, with the approval of aducanumab in 2021 and lecanemab in 2023. The pipeline also includes agents targeting neuropsychiatric symptoms, with 31% of current drugs being repurposed agents. The total development time for a potential Alzheimer's disease therapy to progress from nonclinical studies to FDA review is approximately 13 years.