---
title: "Remternetug | PepTracker Pro"
url: https://peptrackerpro.com/peptides/remternetug
description: "Remternetug (development code LY3372993) is an investigational IgG1 monoclonal antibody from Eli Lilly that binds a pyroglutamate-modified form of amyloid-beta (N3pG-Aβ) found almost exclusively in the aggregated plaques of Alzheimer's disease. It is the follow-on to donanemab (Kisunla), Lilly's FDA-approved anti-amyloid antibody that hits the same target, and is designed to clear existing brain amyloid rapidly and, distinctively, to be delivered by a short subcutaneous injection that patients or care partners can give at home rather than only by intravenous infusion in a clinic. In an early-phase study three-quarters of treated participants reached the amyloid-clearance threshold within about six months, and remternetug is now in Phase 3 across symptomatic early Alzheimer's (TRAILRUNNER-ALZ 1), a large prevention program (TRAILRUNNER-ALZ 3), and inherited-Alzheimer prevention through the DIAN-TU network. It is not approved by the FDA or any regulator for any use."
lang: en
---

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# Remternetug

Medium Evidence

Remternetug (development code LY3372993) is an investigational IgG1 monoclonal antibody from Eli Lilly that binds a pyroglutamate-modified form of amyloid-beta (N3pG-Aβ) found almost exclusively in the aggregated plaques of Alzheimer's disease. It is the follow-on to donanemab (Kisunla), Lilly's FDA-approved anti-amyloid antibody that hits the same target, and is designed to clear existing brain amyloid rapidly and, distinctively, to be delivered by a short subcutaneous injection that patients or care partners can give at home rather than only by intravenous infusion in a clinic. In an early-phase study three-quarters of treated participants reached the amyloid-clearance threshold within about six months, and remternetug is now in Phase 3 across symptomatic early Alzheimer's (TRAILRUNNER-ALZ 1), a large prevention program (TRAILRUNNER-ALZ 3), and inherited-Alzheimer prevention through the DIAN-TU network. It is not approved by the FDA or any regulator for any use.

Aliases Remternetug +6 more

Evidence Medium Evidence

Last Updated 2026-09-20

Reading Time 6 min

## What It Is

Remternetug (LY3372993) is a humanized IgG1 monoclonal antibody directed against N3pG-Aβ, an N-terminally truncated, pyroglutamate-modified species of amyloid-beta that is generated within, and largely confined to, the fibrillar amyloid plaques that define Alzheimer's disease. Because this epitope is a marker of deposited plaque rather than soluble, circulating amyloid, an antibody that recognizes it can engage microglia (via the antibody Fc region) to phagocytose and remove established plaque while sparing normal amyloid precursor processing. Remternetug is the second Lilly antibody built on this strategy, following donanemab (Kisunla), and it is being developed with two goals that address the practical limitations of the first generation of anti-amyloid drugs: achieving rapid, deep amyloid clearance, and enabling subcutaneous self-administration so that treatment does not depend on repeated in-clinic infusions. Across its Phase 1 and Phase 3 programs remternetug has been given both intravenously and subcutaneously, and a Phase 3 sub-analysis has shown that many patients or their study partners can perform the injections themselves. As with the whole anti-amyloid class, the central safety issue is amyloid-related imaging abnormalities (ARIA) - brain swelling or microbleeds seen on MRI - which are more common in APOE ε4 carriers and require MRI monitoring. Remternetug remains investigational and is not approved for any indication.

Also known as: Remternetug, LY3372993, LY-3372993, N3pG-Abeta mAb, N3pG-Aβ monoclonal antibody, anti-amyloid antibody, pyroglutamate amyloid-beta antibody

## Regulatory Status

Investigational - Phase 3 (not approved)

Remternetug (LY3372993) is an investigational anti-amyloid IgG1 monoclonal antibody from Eli Lilly and is not approved by the FDA or any other regulatory agency for Alzheimer's disease or any other use. It targets pyroglutamate-modified amyloid-beta (N3pG-Aβ), the same epitope as Lilly's FDA-approved antibody donanemab (Kisunla). Remternetug is in a broad Phase 3 program: TRAILRUNNER-ALZ 1 (NCT05463731) in early symptomatic AD, with intravenous and subcutaneous dosing and a primary endpoint of the proportion of patients reaching amyloid plaque clearance; TRAILRUNNER-ALZ 3 (NCT06653153), a large event-driven prevention/early-AD study using subcutaneous dosing and time to clinical progression (Clinical Dementia Rating) as the primary endpoint; and the Knight Family DIAN-TU Primary Prevention Trial (NCT06647498), where remternetug replaced gantenerumab for people with autosomal-dominant Alzheimer's mutations, dosed subcutaneously four times per year for two years. As with all amyloid-clearing antibodies, safe use depends on APOE genotyping and serial MRI monitoring for amyloid-related imaging abnormalities (ARIA). Definitive clinical-outcome (cognition and function) data from the Phase 3 program have not yet been reported.

## Why Researchers Study It

Researchers study remternetug because it tests two ideas that could reshape amyloid-targeting therapy for Alzheimer's disease. The first is depth and speed of plaque removal: by binding N3pG-Aβ, a pyroglutamate-modified amyloid species found in established plaques, remternetug (like its predecessor donanemab) aims to strip deposited amyloid quickly, and its early data - roughly three-quarters of treated participants reaching the amyloid-clearance threshold within about six months - suggest that goal is achievable. The second, and more novel, idea is delivery. The first anti-amyloid antibodies require repeated intravenous infusions in an infusion center, a major barrier to access; remternetug is being developed for subcutaneous injection, and a Phase 3 sub-analysis has shown that a meaningful share of patients or their study partners can give the injections themselves. If a subcutaneous, self-administered antibody can match the plaque clearance of infused drugs while being far easier to deliver, it would widen who can realistically be treated. Remternetug is also a key test of the amyloid hypothesis in prevention: through TRAILRUNNER-ALZ 3 and the DIAN-TU network it is being studied in people before or at the earliest stages of symptoms, where clearing amyloid might delay clinical decline rather than only treat it.

## Proposed Mechanisms

- N3pG-Aβ targeting: remternetug is an IgG1 monoclonal antibody that binds pyroglutamate-modified amyloid-beta (N3pG-Aβ / N3pE-Aβ), a truncated, post-translationally modified amyloid species that is largely restricted to aggregated fibrillar plaques, giving the antibody selectivity for deposited plaque over soluble amyloid.
- Microglial plaque clearance: by coating plaque-associated amyloid, the antibody's Fc region engages Fc-gamma receptors on microglia, triggering phagocytosis and removal of established amyloid deposits (opsonization-mediated clearance), the same mechanism validated by donanemab.
- Rapid, deep amyloid reduction: the plaque-selective epitope allows aggressive clearance so that many patients reach a pre-specified amyloid-negative threshold (centiloid-based) within months, after which dosing can, in principle, be stopped.
- Subcutaneous delivery: remternetug is formulated for subcutaneous injection as well as intravenous infusion, aiming to achieve plaque-clearing exposure through at-home dosing rather than requiring in-clinic infusion.
- Prevention hypothesis: in cognitively unimpaired or very early populations (TRAILRUNNER-ALZ 3, DIAN-TU), removing or preventing amyloid accumulation is hypothesized to delay downstream tau spread, neurodegeneration and clinical progression.

## Evidence Snapshot

Medium Evidence

Low

Medium

High

| Study Type | Model | Outcome | Link |
| --- | --- | --- | --- |
| Phase 1 multiple-ascending-dose (MAD) study in Alzheimer's disease (interim analysis presented at AD/PD 2023). | 41 participants aged 59-84 with mild cognitive impairment or mild-to-moderate AD dementia, randomized 1:5 to intravenous placebo or remternetug 250-2800 mg every 4 weeks, with brain amyloid measured by florbetapir PET at screening, day 85 and day 169. | By day 169, 75% (18 of 24) of participants receiving 700-2800 mg reached amyloid clearance (below ~24.1 centiloids). No treatment-emergent anti-drug antibodies were detected. ARIA was the most common treatment-emergent adverse event, seen in 10 participants, including 1 symptomatic case - supporting advancement to Phase 3. | Source |
| Phase 3 TRAILRUNNER-ALZ 1 (NCT05463731) - subcutaneous self-administration feasibility sub-analysis (presented at CTAD 2025). | 197 participants with early (stage 3-4) symptomatic AD who received at least one subcutaneous injection of remternetug or placebo (weekly or monthly cohorts); feasibility of self- or study-partner administration assessed. | 58 of 197 (29.4%) self-administered at least once (mean 8.6 self-injections). Among participants with any non-healthcare-professional injection, 88.5% of injections were given by the patient (43.1%) or a study partner (45.4%) and only 10.5% by a healthcare professional - indicating subcutaneous self-administration is practical, especially for earlier-stage patients. | Source |
| Phase 3 TRAILRUNNER-ALZ 3 (NCT06653153) - prevention/early-AD trial design (presented at CTAD 2024). | Multicenter, randomized, double-blind, placebo-controlled, event-driven trial of subcutaneous remternetug in early AD (600 in the double-blind period plus a 974-participant open-label safety cohort), incorporating decentralized/remote assessments; up to ~255 weeks. | Primary endpoint is time to clinical progression, defined as an increase in the Clinical Dementia Rating (CDR) score, with secondary endpoints spanning cognition, function, safety, pharmacokinetics and immunogenicity; the trial is testing whether early amyloid clearance can delay clinical decline (outcomes pending). | Source |

## Commonly Discussed Benefits

Cognition: https://peptrackerpro.com/benefits/cognition
Neuroprotection: https://peptrackerpro.com/benefits/neuroprotection
Disease Modification: https://peptrackerpro.com/benefits/disease-modification

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## Safety & Cautions

- Remternetug is an investigational anti-amyloid antibody that is NOT approved by the FDA or any regulator for Alzheimer's disease or any other condition. It is administered only within clinical trials under medical supervision; any product sold as 'remternetug' or 'LY3372993' outside a legitimate trial or clinic is unverified and should not be used.
- The defining risk of the anti-amyloid class is amyloid-related imaging abnormalities (ARIA) - ARIA-E (brain edema/effusion) and ARIA-H (microhemorrhages and superficial siderosis) - which can be asymptomatic or, less often, cause headache, confusion, visual changes or, rarely, serious events; ARIA was the most common treatment-emergent adverse event in the Phase 1 study (10 participants, 1 symptomatic).
- ARIA risk is substantially higher in carriers of the APOE ε4 gene, especially homozygotes, so genotyping and serial MRI monitoring are integral to safe use of amyloid-clearing antibodies.
- Anticoagulant or antithrombotic use may raise the risk of serious hemorrhage in the setting of ARIA-H; concomitant medications and bleeding risk need careful review, as with donanemab and lecanemab.
- Subcutaneous dosing can cause injection-site reactions, and any monoclonal antibody can provoke infusion or hypersensitivity reactions; long-term efficacy on cognition and function for remternetug specifically has not yet been established, as its Phase 3 clinical-outcome data are still maturing.
- This profile is educational information about a compound under investigation, not medical advice; decisions about anti-amyloid therapy should be made with a qualified clinician.

## Comparisons

See how Remternetug compares to related peptides:

Remternetug vs Cerebrolysin: https://peptrackerpro.com/compare/remternetug-vs-cerebrolysin

Remternetug vs Davunetide: https://peptrackerpro.com/compare/remternetug-vs-davunetide

Remternetug vs Dihexa: https://peptrackerpro.com/compare/remternetug-vs-dihexa

Remternetug vs Klotho (Alpha-Klotho): https://peptrackerpro.com/compare/remternetug-vs-klotho

Remternetug vs Semax: https://peptrackerpro.com/compare/remternetug-vs-semax

Remternetug vs Trontinemab: https://peptrackerpro.com/compare/remternetug-vs-trontinemab

## Calculator Tools

Use our research tools to explore dosing and reconstitution data:

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## Citations

1. [1] Remternetug - ALZFORUM Therapeutics PubMed (https://www.alzforum.org/therapeutics/remternetug)
2. [2] A Study of Remternetug (LY3372993) in Participants With Alzheimer's Disease (TRAILRUNNER-ALZ 1) - ClinicalTrials.gov NCT05463731 PubMed (https://clinicaltrials.gov/study/NCT05463731)
3. [3] A Study of Remternetug (LY3372993) in Early Alzheimer's Disease (TRAILRUNNER-ALZ 3) - ClinicalTrials.gov NCT06653153 PubMed (https://clinicaltrials.gov/study/NCT06653153)
4. [4] Early Phase 3 Data Highlight Convenience and Feasibility of Self-Administered Alzheimer Agent Remternetug - NeurologyLive PubMed (https://www.neurologylive.com/view/early-phase-3-data-highlight-convenience-feasibility-self-administered-alzheimer-agent-remternetug)
5. [5] Phase 3 TRAILRUNNER-ALZ 3 to Test Effects of IgG1 Monoclonal Antibody Remternetug in Early Alzheimer Disease - NeurologyLive PubMed (https://www.neurologylive.com/view/phase-3-trailrunner-alz-3-test-effects-igg1-monoclonal-antibody-remternetug-early-alzheimer-disease)
6. [6] Eli Lilly's Remternetug Demonstrates Significant Amyloid Plaque Removal in Early-Stage Trial - NeurologyLive PubMed (https://www.neurologylive.com/view/eli-lilly-remternetug-demonstrates-significant-amyloid-plaque-removal-early-stage-trial)
7. [7] A Study of a Potential Disease Modifying Treatment in Individuals at Risk for or With Early Onset AD Caused by a Genetic Mutation (Knight Family DIAN-TU) - ClinicalTrials.gov NCT06647498 PubMed (https://clinicaltrials.gov/study/NCT06647498)
8. [8] Remternetug - Wikipedia PubMed (https://en.wikipedia.org/wiki/Remternetug)

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A porcine brain-derived peptide mixture approved in some countries for stroke recovery and neurodegenerative conditions.

Neuroprotection: https://peptrackerpro.com/benefits/neuroprotection
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\+ Compare: https://peptrackerpro.com/compare?select=davunetide
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Cognition: https://peptrackerpro.com/benefits/cognition
Neuroprotection: https://peptrackerpro.com/benefits/neuroprotection
Anti-Aging: https://peptrackerpro.com/benefits/anti-aging
Longevity: https://peptrackerpro.com/benefits/longevity

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Mood: https://peptrackerpro.com/benefits/mood
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### Trontinemab

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An investigational, brain-penetrant anti-amyloid antibody from Roche/Genentech that uses the proprietary 'Brainshuttle' transferrin-receptor delivery system to reach the brain far more efficiently than conventional antibodies. Trontinemab (development codes RG6102 / RO7126209) is a 2+1 bispecific molecule: it fuses the amyloid-beta-clearing antibody gantenerumab to a fragment that grabs transferrin receptor 1 (TfR1) on blood-brain-barrier cells, hitching a ride into the brain via the same receptor-mediated transport that carries iron. That shuttle lets a low intravenous dose clear amyloid plaques rapidly and deeply while triggering strikingly little of the brain swelling and micro-bleeding (ARIA) that limits approved anti-amyloid drugs. In the Phase Ib/IIa Brainshuttle AD study (NCT04639050), the 3.6 mg/kg dose removed roughly 107 centiloids of amyloid after 28 weeks, driving about 91-92% of participants below the amyloid-positivity threshold (24 centiloids) - with ARIA-E seen in fewer than 5% of participants, well below the ~13% reported for lecanemab and ~24% for donanemab. On the strength of those data, Roche launched two identical pivotal Phase 3 trials - TRONTIER 1 and TRONTIER 2 - in early symptomatic Alzheimer's disease (about 1,600 patients across 18 countries, begun in 2025), and at the 2026 Alzheimer's Association International Conference (AAIC) in London it unveiled PrevenTRON, a Phase 3 prevention trial in 1,600 cognitively unimpaired people at high risk (elevated plasma p-tau217). Trontinemab is a prescription-stage investigational biologic - it is not approved anywhere and is not a supplement or research chemical.

View Details: https://peptrackerpro.com/peptides/trontinemab

\+ Compare: https://peptrackerpro.com/compare?select=trontinemab
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