Highly anticipated studies looked at whether oral semaglutide could slow the progression of Alzheimer’s disease. Unfortunately, it didn’t.
In Phase 3 trials, more than 3,800 adults who were receiving care for Alzheimer’s were given either oral semaglutide or a placebo. The medication was no better than the placebo at delaying the progression of the disease. Oral semaglutide has been shown to aid Alzheimer’s-related biomarkers, so the researchers at Novo Nordisk were hoping it would fight the condition itself.
“Based on the significant unmet need in Alzheimer’s disease as well as a number of indicative data points, we felt we had a responsibility to explore semaglutide’s potential, despite a low likelihood of success,” said Dr. Martin Holst Lange, chief scientific officer and executive vice president of research and development at Novo Nordisk, while thanking the trial participants.
The drug does improve the biomarkers for Alzheimer’s, so it may still be helpful as a preventative measure, just not a treatment.
“Considering the amount of real-world evidence emerging in the field, we really need to evaluate whether these agents work more for prevention rather than treatment of established cases,” said Dr. Paul Edison, a professor of neuroscience at Imperial College London who is studying GLP-1 medications in relation to cognitive decline.
The company always viewed the Alzheimer’s trials as a “lottery ticket.” Novo Nordisk was hopeful, but not holding their breath. However, despite the company going in with realistic expectations, the general public’s disappointment was reflected in Novo Nordisk’s falling stock value.
While the public is disappointed, scientists view it differently. In research, studies are often about ruling things out and finding new possibilities at the same time. The fact that it improved biomarkers for Alzheimer’s is promising. A study in April with almost 400,000 people found that folks taking GLP-1s had a 33 percent lower risk of developing dementia.
There is "a tiny window of hope that in future this drug might be effective if used earlier as a preventative strategy," said Prof. Tara Spires-Jones, director of the Centre for Discovery Brain Sciences at the Univ. of Edinburgh.
She added, “Future trials are needed to confirm whether GLP-1 drugs might be effective in preventing Alzheimer’s disease.”
"When we look back at very large populations, people who got GLP-1s appeared to not get Alzheimer's disease as frequently as people who did not take it or who took different diabetes medications," said Dr. Steven DeKosky of the Univ. of Florida's Alzheimer’s Disease Research Center. He was a part of the April study.
