Samba Trials' Q2 2026 scan identified 29 industry-sponsored, actively-recruiting neurology trials in Brazil — 5.0% of the country's 582-trial total. The neurology footprint is smaller than oncology (250) or cardiovascular (35) but concentrated at a handful of academic-neurology centers whose investigators have been running multinational MS, migraine, and Alzheimer's programs for more than two decades.
For biotechs evaluating Brazil for a neurology or neurodegenerative protocol, the practical question is rarely "does the capacity exist." It does. The question is which specific centers are currently running a competing-mechanism trial that will cap enrollment for your protocol, and which PIs will actually respond to CRO outreach within a workable timeline. That's consultancy work, not data-scraping.
Why Brazil for neurology
- Established multi-decade PI bench. Brazilian neurology investigators have been running multinational MS trials since the early 2000s (with Biogen, Novartis, Roche, Sanofi), migraine CGRP-class trials since the mid-2010s, and Alzheimer's anti-amyloid trials across the crenezumab/gantenerumab/aducanumab eras. The muscle memory is there.
- SUS-integrated patient access. Multiple sclerosis patients in Brazil flow through SUS CEAFs (Componentes Especializados da Assistência Farmacêutica) — a drug-delivery program that centralizes patient records around a small number of academic neurology services. That concentrates trial-eligible patients at the same centers where industry trials run, which is the opposite of the fragmentation problem in many U.S. markets.
- Rare-neurology patient populations. Brazilian neurogenetics referral networks (particularly HCPA's Serviço de Genética Médica, one of the oldest in Latin America) aggregate SMA, Duchenne, Huntington's, familial ALS, and Pompe patients in ways that make trial recruitment tractable even for ultra-rare indications.
- Imaging infrastructure. 3T MRI is widely available at academic centers; PET-amyloid and PET-tau are available at HCPA, Albert Einstein, Sírio-Libanês, and Moinhos de Vento with protocols already established for multinational Alzheimer's trials.
Where the neurology trials run
Neurology is the area where HCPA's dominance is clearest. A well-structured Brazilian neurology Phase 3 activation will combine HCPA with one or two São Paulo academic centers, Moinhos de Vento in Porto Alegre for an imaging-heavy arm, and Hospital São Lucas da PUCRS for demyelinating-disease recruitment.
| Center | City / State | Role for neurology trials |
|---|---|---|
| Hospital de Clínicas de Porto Alegre (HCPA) | Porto Alegre, RS | 53 active industry trials; Latin-American reference for MS, rare neurology, and neurogenetics. UFRGS-affiliated. |
| Hospital São Lucas da PUCRS | Porto Alegre, RS | 30 trials; strong MS and migraine PI bench; PUCRS-affiliated. |
| Hospital Moinhos de Vento | Porto Alegre, RS | 22 trials; private-sector neuroimaging capacity and Alzheimer's trial experience. |
| Hospital das Clínicas da FMUSP (implied across SP metro) | São Paulo, SP | São Paulo accounts for 454 city-level trial-site records; academic neurology at USP is a default inclusion for multinational programs. |
| Hospital Alemão Oswaldo Cruz | São Paulo, SP | 20 trials; private-academic hybrid with neuroimaging and Alzheimer's trial capacity. |
| Hospital Sírio-Libanês | São Paulo, SP | 12 trials; Instituto do Cérebro arm; neuro-oncology and neurodegenerative research. |
Geographically, neurology trial activity concentrates in Rio Grande do Sul (189 total trials state-wide, with Porto Alegre alone at 350 site-level records) and São Paulo (252 state-wide, 454 in SP metro). Minas Gerais (75), Paraná (93), and the Federal District (48, anchored by Brasília's academic neurology group) are secondary hubs.
Who's sponsoring neurology trials in Brazil
Brazil's top-25 industry sponsors with heavy neurology pipelines are visible in our Q2 2026 data: Hoffmann-La Roche (31 total active trials), Novartis (33), Sanofi (21), Biogen (6), Eli Lilly (28), and Janssen Research & Development (28). Roche (Ocrevus, Enspryng), Novartis (Kesimpta, remibrutinib), and Sanofi (tolebrutinib, frexalimab) anchor the MS franchise. Lilly (donanemab) and Biogen (Leqembi) anchor Alzheimer's. Multiple emerging biotechs run CGRP, anti-seizure, and rare-neurology programs through the same centers.
Honest framing: these are overall active-trial counts, not neurology-only counts. We don't break sponsor rankings down by TA in the free data. That said, Roche, Novartis, Biogen, and Sanofi's Brazilian presence is substantially weighted toward neurology — their other TAs are smaller in Brazil than their global footprints would suggest. TA-specific sponsor rankings are available in the full quarterly landscape report.
Rare-neurology opening
Brazil has 25 industry-sponsored rare-disease trials in Q2 2026 — and rare neurology (SMA, DMD, Huntington's, ALS subtypes, rare leukodystrophies, Pompe) is a major share. HCPA's neurogenetics unit has been running rare-disease trials for sponsors like Alexion Pharmaceuticals (8 active trials), Azafaros A.G. (4), and Genzyme/Sanofi (4) for years. For emerging biotechs with ultra-rare neurology assets, the Brazilian patient-aggregation dynamic is a material advantage.
Regulatory path: neurology considerations
Brazilian regulation runs three parallel tracks: CEP (local site ethics), CONEP (central ethics, required for multinational and genetic studies — nearly all neurology trials), and ANVISA (the drug-specific clinical-trial dossier). Historical end-to-end timelines ran 9-12 months; under Lei 14.874/2024 the target is a ~6-month pathway, with well-run submissions now activating in 6-8 months when CEP/CONEP/ANVISA are handled in parallel from day one.
Neurology-specific considerations worth flagging:
- Genetic-material export is heavily regulated. Most neurology trials now include a pharmacogenomic or biomarker sub-study. CONEP authorization and a formal Termo de Transferência de Material Biológico are required for sample export — plan for this in the dossier from the start, not as an amendment.
- Imaging-core-lab data flow. Central imaging review (for MS volumetric MRI, PET-amyloid Alzheimer's endpoints) is standard; most centers have pre-existing BIDS/DICOM export pipelines to global core labs, but site-level qualification adds 4-8 weeks to activation.
- Informed-consent linguistic adaptation. Neurology consent documents average 30-50 pages and require fluent Brazilian Portuguese adaptation with patient-friendly plain-language summaries. CEP review often lands on ICF clarity; build in time for this.
How Samba Trials helps
Samba Trials is the clinical-trials consultancy arm of BioAlma. We work with sponsors before CRO selection, during feasibility, and through site activation:
- TA-specific feasibility memos. A 2-3 week review of your neurology protocol against Brazilian site capacity, competing-mechanism trial overlap (important when multiple anti-CGRP or anti-amyloid programs queue at the same investigators), SUS access pathways for the target population, and enrollment-timeline ranges.
- Site identification and activation support. Named-center shortlists with PI profiles, active-trial load, historical sponsor relationships, and imaging/biomarker capacity. We handle initial outreach.
- ANVISA submission strategy. Parallel-track planning for CEP/CONEP/ANVISA, dossier review against current reviewer expectations, and biospecimen-export strategy for the pharmacogenomics and biomarker arms that now sit in almost every modern neurology protocol.
Get a neurology feasibility memo
Send us your protocol synopsis or target indication. We'll return a Brazil-specific feasibility memo within two weeks — named centers, PI candidates, competing-trial overlap, and realistic enrollment ranges.
Request a memo →