The Alzheimer’s Nasal Spray Nobody Seems to Be Talking About

The Alzheimer’s Nasal Spray Nobody Seems to Be Talking About

Like many people who have watched Alzheimer’s disease affect family members and friends, I had become used to a familiar pattern: a new drug is announced, the headlines sound hopeful, the reality turns out to be more complicated, and the actual benefit for patients is often modest. In recent years, most of the attention has focused on expensive antibody treatments aimed at amyloid or tau, the proteins most associated with Alzheimer’s disease. These drugs have attracted huge investment, regulatory attention, and media coverage.

So, I did not expect a YouTube link from a friend in Florida to lead me somewhere quite different. He had recently been diagnosed with Alzheimer’s at the age of 72, and like many people facing that diagnosis, he was searching for hope beyond the usual headlines. What I first assumed might be just another optimistic online claim led me instead to a published clinical trial from Cuba that investigated an intranasal treatment called NeuroEPO plus, also known as NeuralCIM®.

https://link.springer.com/article/10.1186/s13195-023-01356-w

Sosa, S., Bringas, G., Urrutia, N., Peñalver, A. I., et al. (2023). NeuroEPO plus (NeuralCIM®) in mild-to-moderate Alzheimer’s clinical syndrome: the ATHENEA randomized clinical trial. Alzheimer’s Research & Therapy.

The trial called ATHENEA is not an intravenous treatment aimed mainly at clearing amyloid from the brain. It is an intranasal treatment, administered through the nose, based on a modified form of erythropoietin, a naturally occurring protein better known for its role in red blood cell production.

The claim was striking: in people with mild-to-moderate Alzheimer’s clinical syndrome, NeuroEPO plus appeared to produce better cognitive outcomes than placebo over 48 weeks.

What caught my attention was not just the result. It was the silence around it.

If a nasal treatment for Alzheimer’s really showed this level of promise, why was it not being discussed everywhere? Why were universities, charities, governments, and pharmaceutical companies not urgently trying to replicate it? Why was there no obvious wave of major international follow-up trials?

So, I kept looking.

I found some later references and a 2025 post-trial observational follow-up study, but I could not find a major new randomized international Alzheimer’s trial from 2024–2026 confirming or refuting the Cuban findings. Most of what I found either came from the same research ecosystem, reviewed the earlier evidence, or mentioned NeuroEPO plus in the broader context of erythropoietin, brain protection, or nose-to-brain drug delivery.

That does not mean the Cuban research is wrong. But it does mean the evidence sits in an unusual place: too interesting to ignore, yet not independently confirmed enough to call it a proven breakthrough.

And that is where the story becomes more complicated.

Alzheimer’s research is not just science. It is also money, regulation, patents, politics, reputation, and momentum. Large pharmaceutical companies in the USA and Europe have spent billions pursuing amyloid and tau-based approaches. Entire research programmes, manufacturing systems, clinical trial networks, and commercial expectations are built around those theories. A Cuban-developed intranasal biologic, especially one sitting outside the dominant commercial model, may not easily attract the same attention.

That does not prove deliberate neglect. But it does raise a fair question: if the ATHENEA results are even partly correct, why has the wider Alzheimer’s world not rushed to test them?

There is another problem too, and it affects all Alzheimer’s trials, not just this one.

Alzheimer’s does not progress neatly. Two people can both be described as having “mild” Alzheimer’s and yet decline at very different rates. One person may deteriorate quickly. Another may remain relatively stable for longer. Current tests can estimate stage and impairment, but they cannot perfectly predict each person’s future path.

That makes drug trials difficult to interpret. If a drug trial reports that some patients declined more slowly, we have to ask: did the drug cause that slower decline, or would some of those people have declined slowly anyway? Randomised placebo-controlled trials are designed to reduce that uncertainty, but they cannot remove it completely, especially when the claimed benefit is small.

This is one reason why some of the recently approved Alzheimer’s drugs remain controversial. They may show a measurable average slowing across a group, but that does not necessarily mean the benefit is dramatic, predictable, or meaningful for every patient in real life.

And this is also why NeuroEPO plus deserves both interest and caution.

The ATHENEA results look promising. The 2025 follow-up study appears to suggest that people who continued or started NeuroEPO plus may have stabilized or declined more slowly than untreated controls. But an observational follow-up is not the same as a new, blinded, placebo-controlled international trial.

So where does that leave us?

For me, it leaves NeuroEPO plus in a strange and important limbo. It should not be dismissed simply because it comes from Cuba. It should not be accepted uncritically either. If the findings are real, they could matter enormously. If they are not, families deserve to know that too.

The only way forward is independent testing.

Not more hype. Not silence. Not commercial defensiveness. Not blind faith in either Western pharmaceutical pipelines or Cuban biotech claims.

Just proper, independent, international trials.

Because if there is even a chance that a relatively simple nasal treatment could slow or stabilise Alzheimer’s disease, then the world should want to know. And families living with Alzheimer’s should not have to rely on scattered papers, unanswered questions, and a silence that feels far too loud.

Every article I publish reflects my personal views, informed by the evidence available at the time of writing. My aim is to support honest, compassionate and informed discussion, not to provide individual medical advice.

Kevin Hewlett MBE MSc (Dementia)

kevin.hewlett@haleplace.co.uk

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