---
title: "Remternetug (LY3372993): Lilly's Next Anti-Amyloid Antibody Bets on an Injection You Can Give Yourself (September 20, 2026) | PepTracker Pro Blog"
url: https://peptrackerpro.com/blog/remternetug-ly3372993-eli-lilly-anti-amyloid-n3pg-monoclonal-antibody-pyroglutamate-amyloid-beta-alzheimers-disease-donanemab-follow-on-subcutaneous-self-administration-trailrunner-alz-1-trailrunner-alz-3-dian-tu-amyloid-plaque-clearance-centiloids-aria-phase-3-september-20-2026
description: "Remternetug (LY3372993) is Lilly's follow-on to donanemab: an anti-amyloid antibody engineered to clear brain plaque fast and, unusually, to be injected under the skin at home. Here's what the Phase 1 and Phase 3 data actually show, and where the questions still are."
lang: en
---

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Research & Compounds

Research & Compounds

# Remternetug (LY3372993): Lilly's Next Anti-Amyloid Antibody Bets on an Injection You Can Give Yourself (September 20, 2026)

PepTracker Pro Research Team September 20, 2026 9 min read

## Table of Contents

- A second shot at the amyloid plaque
- The number that got people's attention
- The real innovation is the syringe, not the target
- Phase 3 evidence that patients can do it themselves
- Three trials, from symptoms to prevention
- The catch every anti-amyloid antibody shares: ARIA
- Where remternetug sits, and what we still don't know

## A second shot at the amyloid plaque

Remternetug (development code LY3372993) is Eli Lilly's next anti-amyloid antibody, and it is easiest to understand as a deliberate sequel. Lilly's first drug in this class, donanemab (marketed as Kisunla), is an FDA-approved antibody that binds a specific, plaque-bound form of amyloid-beta - a truncated, pyroglutamate-modified species called N3pG-Aβ that is generated inside amyloid deposits and is largely absent from healthy tissue. Because that epitope flags established plaque rather than free-floating amyloid, an antibody against it can recruit the brain's microglia to phagocytose and remove deposits with relatively little off-target activity. Remternetug hits the same target with the same basic logic, but it is engineered to push two things further: how fast and deeply it clears plaque, and how the drug is delivered.

## The number that got people's attention

The clearest efficacy signal so far comes from an early Phase 1 multiple-ascending-dose study, presented at the 2023 AD/PD conference. Forty-one participants aged 59 to 84 with mild cognitive impairment or mild-to-moderate Alzheimer's dementia were randomized 1:5 to intravenous placebo or remternetug at doses from 250 to 2800 mg every four weeks, with brain amyloid tracked by florbetapir PET. By day 169 - less than six months in - 75 percent of participants on the 700-to-2800 mg doses, 18 of 24, had cleared amyloid below the roughly 24.1-centiloid threshold used to define an amyloid-negative scan. No treatment-emergent anti-drug antibodies were detected. That is a fast, deep clearance signal, consistent with the idea that a plaque-selective antibody can strip deposits and then, in principle, stop.

## The real innovation is the syringe, not the target

What makes remternetug strategically interesting is not that it clears amyloid - donanemab and lecanemab already do - but how Lilly wants to give it. The first generation of anti-amyloid antibodies requires repeated intravenous infusions in an infusion center, which is a genuine bottleneck: it limits how many patients can be treated and where. Remternetug is being developed for subcutaneous injection, a quick shot under the skin, and Lilly has gone a step further and tested whether patients or their care partners can give it themselves. If a self-administered antibody can match the plaque clearance of an infused one, the practical reach of amyloid therapy widens dramatically.

## Phase 3 evidence that patients can do it themselves

At the 2025 CTAD conference, Lilly reported a feasibility sub-analysis from the Phase 3 TRAILRUNNER-ALZ 1 trial. Among 197 participants with early symptomatic Alzheimer's who received at least one subcutaneous injection, 58 (29.4 percent) self-administered at least once, averaging 8.6 self-injections. Looking at all the non-clinician injections, 88.5 percent were given by the patient (43.1 percent) or a study partner (45.4 percent), with only about one in ten delivered by a healthcare professional. Self-administration was more common in people with milder cognitive impairment - unsurprising, but important, because it suggests the at-home model works best exactly where amyloid therapy is increasingly aimed: early.

## Three trials, from symptoms to prevention

Remternetug's Phase 3 program is unusually broad. TRAILRUNNER-ALZ 1 (NCT05463731) studies people with early symptomatic Alzheimer's, allowing both intravenous and subcutaneous dosing, with the proportion of patients reaching amyloid plaque clearance as its primary endpoint. TRAILRUNNER-ALZ 3 (NCT06653153) is a much larger, event-driven prevention-oriented study in early AD that uses subcutaneous dosing, decentralized and remote assessments, and - notably - a clinical primary endpoint: time to progression measured by an increase in the Clinical Dementia Rating score. And through the Dominantly Inherited Alzheimer Network, remternetug replaced gantenerumab in the Knight Family DIAN-TU Primary Prevention Trial (NCT06647498) for people carrying autosomal-dominant Alzheimer's mutations, dosed four times a year for two years. Together these test not just whether remternetug removes plaque, but whether removing it early changes the course of the disease.

## The catch every anti-amyloid antibody shares: ARIA

The class-defining risk is amyloid-related imaging abnormalities, or ARIA - brain swelling (ARIA-E) or small bleeds and siderosis (ARIA-H) that show up on MRI. In remternetug's Phase 1 study, ARIA was the most common treatment-emergent adverse event, occurring in 10 participants, one of them symptomatic. ARIA is more frequent and more severe in carriers of the APOE ε4 gene, especially those with two copies, which is why APOE genotyping and serial MRI monitoring are built into how these drugs are used, and why anticoagulant use raises particular concern. Moving to subcutaneous dosing does not remove this risk; it changes the logistics of delivery, not the underlying biology of clearing plaque from an aging brain.

## Where remternetug sits, and what we still don't know

Remternetug is investigational and not approved anywhere; anything sold online as 'remternetug' or 'LY3372993' is unverified and not the trial drug. It also should not be confused with a different Alzheimer's approach getting attention - Roche's trontinemab, a 'brain-shuttle' antibody that hitches a ride across the blood-brain barrier via the transferrin receptor to boost brain exposure. Remternetug's bet is simpler and more logistical: same validated target as donanemab, engineered for rapid clearance and a shot you can give at home. The open question is the one that matters most and is still unanswered - whether that fast, convenient plaque clearance translates into a meaningful slowing of cognitive and functional decline. That is what the Phase 3 clinical endpoints, still maturing, are designed to show. This article is educational and not medical advice.

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## Citations

1. [1] Remternetug - ALZFORUM Therapeutics Source (https://www.alzforum.org/therapeutics/remternetug)
2. [2] Early Phase 3 Data Highlight Convenience and Feasibility of Self-Administered Alzheimer Agent Remternetug - NeurologyLive Source (https://www.neurologylive.com/view/early-phase-3-data-highlight-convenience-feasibility-self-administered-alzheimer-agent-remternetug)
3. [3] Phase 3 TRAILRUNNER-ALZ 3 to Test Effects of IgG1 Monoclonal Antibody Remternetug in Early Alzheimer Disease - NeurologyLive Source (https://www.neurologylive.com/view/phase-3-trailrunner-alz-3-test-effects-igg1-monoclonal-antibody-remternetug-early-alzheimer-disease)
4. [4] Eli Lilly's Remternetug Demonstrates Significant Amyloid Plaque Removal in Early-Stage Trial - NeurologyLive Source (https://www.neurologylive.com/view/eli-lilly-remternetug-demonstrates-significant-amyloid-plaque-removal-early-stage-trial)
5. [5] A Study of Remternetug (LY3372993) in Participants With Alzheimer's Disease (TRAILRUNNER-ALZ 1) - ClinicalTrials.gov NCT05463731 Source (https://clinicaltrials.gov/study/NCT05463731)
6. [6] A Study of Remternetug (LY3372993) in Early Alzheimer's Disease (TRAILRUNNER-ALZ 3) - ClinicalTrials.gov NCT06653153 Source (https://clinicaltrials.gov/study/NCT06653153)

**Disclaimer:** This article is for educational purposes only and does not constitute medical advice. Always consult a licensed healthcare provider. Read full research disclaimer → (https://peptrackerpro.com/research-disclaimer)

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