Neurology
NeuralCIM (NeuroEPO) for Alzheimer's Disease: What the Research Shows
What NeuralCIM, a nasal medicine developed in Cuba, is, who it is licensed for, what the studies found and which documents a specialist needs to review a file. Explained in plain words.
NeuralCIM is a form of erythropoietin given through the nose (NeuroEPO), made by Cuba's Center of Molecular Immunology (CIM). On 28 July 2025 the Cuban regulator CECMED granted it a conditional licence for mild and moderate Alzheimer's disease. In the one-year, placebo-controlled ATHENEA trial, memory scores of patients on NeuralCIM improved on average while those on placebo declined, and in longer follow-up the difference held at two and three years. It does not remove Alzheimer's disease and does not replace current medicines. The first dose is given under the supervision of a health professional; a trained family member can then continue at home. Whether it suits a patient is decided by the neurologist who reviews the file.
Where it fits
An addition to Alzheimer's treatment
NeuralCIM does not replace the Alzheimer's medicines a patient already takes; the doctor considers it alongside current treatment. Its licence covers only mild and moderate Alzheimer's disease, so the same results should not be expected in advanced disease or other types of dementia.
The licence is conditional: CECMED asked for the results of confirmatory studies and requires treatment to be supervised by a specialist experienced in Alzheimer's disease. It has no US (FDA) or European Union (EMA) approval.
Key facts
Three things to know about NeuralCIM
Whether a medicine is licensed, who it is licensed for and whether it suits your loved one are separate questions.
- 01
Who it is for
The licence covers mild and moderate Alzheimer's disease. A neurology or psychiatry report and tests such as MMSE, MoCA or CDR show the diagnosis and stage.
- 02
How it is given
Three times a week on alternate days; 0.25 mL into each nostril (a 0.5 mg dose). No hospital stay is needed. Treatment lasts at least one year.
- 03
Who decides
The neurologist who reviews the file decides whether treatment starts, where it starts and how the medicine is supplied.
How it works and how it is given
What is NeuralCIM and how is it given?
The active substance of NeuralCIM is recombinant human erythropoietin with a low sialic acid content (NeuroEPO). Erythropoietin is a protein the body makes itself; the form used for anaemia stimulates blood production. NeuroEPO hardly does this: given into a vein, it is broken down quickly in the liver. It is therefore given through the nose, where it travels along the olfactory nerves to the brain without passing through the liver.
In animal studies NeuroEPO protected nerve cells against lack of oxygen and injury, reduced inflammation and oxidative stress in the brain, raised BDNF, a factor that supports nerve cells, and reduced beta-amyloid build-up in Alzheimer's models. These are laboratory and animal findings; results in people were measured in the clinical studies below.
Each box holds 6 glass vials, 6 single-use syringes and 2 dose limiters. The needle is removed and a dose limiter fitted. The patient lies on their back with a pillow under the shoulders so that the head tilts back about 45 degrees. 0.25 mL is given slowly, drop by drop, into each nostril, and the patient stays in this position for at least 5 minutes.
The first dose is always given under the supervision of a health professional. After training, a family member or carer can continue at home. The medicine is kept in the fridge at 2–8 °C, not frozen and protected from light, and taken out 10 minutes before use. It has no preservative, so an opened vial is used straight away and any rest is thrown away.
What the research shows
What did the clinical studies find?
ADAS-Cog11 is a detailed memory and thinking scale used in Alzheimer's research. A falling score means improvement and a rising score means decline.
- 01
ATHENEA (phase II/III, 48 weeks)
170 people with mild or moderate Alzheimer's (average age 74) took part in this double-blind, placebo-controlled trial. ADAS-Cog11 improved by 3 points with 0.5 mg and 4 points with 1.0 mg, and worsened by 4 points with placebo: differences of 7 and 8 points. 85% of patients completed treatment.
- 02
Long-term follow-up (96 and 144 weeks)
In the observational follow-up, ADAS-Cog11 improved by 6 points at week 96 and 9 points at week 144 in patients who continued, and worsened by 11 and 18 points in a comparison group never treated. The gain shrank in those who stopped. Being observational, this part carries less weight than the randomised trial.
- 03
Phase III study in Cuba
This multicentre, open-label, single-group study enrolled 616 patients; there was no placebo group. After one year, ADAS-Cog11 stayed the same or improved in 61.9% of the patients assessed. Side effects were few.
- 04
Limits of the evidence
Most studies were run in Cuba with the developer taking part. That is why the licence is conditional and larger independent studies are awaited. Results are group averages and not every patient responds the same way.
Video
NeuralCIM in patients' and clinicians' own words
The documentary team Belly of the Beast met patients who travelled to Havana for NeuralCIM and the health professionals who accompany them.
Safety
Side effects and precautions
The points below come from the CECMED-approved product information. The doctor plans monitoring during treatment.
- 01
Common side effects
Burning and itching in the nose, headache and a rise in blood pressure, usually mild, short-lived and reversible. Less often: a blocked nose, sneezing, tiredness, mild fever and a temporary rise in liver values.
- 02
Regular checks
Blood pressure and heart are monitored in people with hypertension or heart disease. Haemoglobin is checked because of rare severe anaemia; severe high blood pressure and heart rhythm problems were also reported as rare serious events.
- 03
Interactions
Zinc sulphate reduces the effect of NeuralCIM. In the studies patients kept taking blood pressure, diabetes, diuretic and antidepressant medicines with no harmful interaction.
- 04
Who should not use it
People allergic to any ingredient. Not recommended in pregnancy or breastfeeding. The nose must be clear; anyone with symptoms that affect driving should not drive until they pass.
Preparing the file
What does the specialist need to see?
To review the file the doctor needs recent records of the diagnosis, the stage and general health. Apply with what you have; we tell you what is missing.
- 01
Neurology report
The latest neurology or psychiatry report stating the Alzheimer's diagnosis and stage; the first diagnosis report if available.
- 02
Memory tests
MMSE, MoCA, CDR or neuropsychological test results; older results show the trend.
- 03
Brain scans
A brain MRI or CT report; a PET or SPECT report if one was done.
- 04
Blood, blood pressure and medicines
Full blood count, B12, TSH, kidney and liver values; blood pressure readings, an ECG and every medicine taken, including zinc supplements.
How we work
Decisions follow the file review
We do not make the medical decision; the doctor in Cuba does. For details see our Alzheimer's treatment and NeuralCIM page.
- 01
Secure application
You send reports through the secure application area, not chat apps. You can apply as a relative.
- 02
Check and translation
We check the documents, translate them into Spanish and prepare one clear file for the doctor.
- 03
The neurologist's opinion
A neurologist in Cuba assesses the diagnosis, the stage and whether NeuralCIM may suit the patient.
- 04
Written plan
If treatment is suggested, we send you in writing where it starts, how the medicine is supplied and the follow-up steps.
Frequently asked questions
Common questions about NeuralCIM
Can NeuralCIM cure Alzheimer's disease?
No. There is no treatment yet that removes Alzheimer's disease. In the studies, memory scores of patients on NeuralCIM were on average maintained or improved; the response varies from person to person.
Is there an age limit?
The product information sets no age limit. The average age in the studies was 74. What matters most is the stage of the disease and general health, not age.
Can treatment be given at home?
Yes. The first dose is supervised by a health professional; after training, a family member or carer can continue at home. No hospital stay is needed.
How long does it last?
According to the product information, at least one year. In the studies results were followed for 48 weeks, two years and three years.
Should current Alzheimer's medicines be stopped?
No, never stop a medicine on your own. NeuralCIM does not replace them; the doctor reviews the medication plan. Only zinc sulphate is known to reduce its effect.
Can we apply for advanced disease or another dementia?
Yes. The licence covers mild and moderate Alzheimer's; in advanced disease or in vascular, Lewy body or frontotemporal dementia NeuralCIM may not be suitable. The doctor gives you a clear opinion.
Sources
The sources behind this article
Wound careHeberprot-P for Diabetic Foot Ulcers: What the Evidence ShowsA calm look at Heberprot-P, a growth factor injected into the wound, how it fits with standard wound care, and the records a specialist needs to see first.Read the article
OncologyCIMAvax-EGF and Vaxira: What Patients Should KnowWhat these Cuban therapeutic cancer vaccines are, where the evidence is still limited, and why an oncologist needs to review your complete file before anything else.Read the article
Patient decisionsHealthcare in Cuba: What International Patients Should EvaluateA calm, balanced guide to weighing treatment in Cuba: the doctors' experience, the quality of coordination, the evidence, the travel itself and care after you return.Read the article
Start with the file
Begin the review with the medical file
Send the reports through the secure application area. We organise the file with you and explain the neurologist's opinion in plain English.
This article is general information. It does not replace a diagnosis, personal treatment advice or a decision on suitability. If you notice sudden difficulty speaking, a drooping face or weakness in an arm, go to the nearest emergency department straight away. Medical disclaimer