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A small clinical trial suggests that drugs like Ozempic may not only help with diabetes and weight loss, but also protect the brain, as people with Alzheimer's lose the ability to think clearly, remember and carry out daily activities. The results must be confirmed in ongoing large trials before the drugs can be approved for the disease.
The study of 204 people with Alzheimer's disease in the United Kingdom showed that the diabetes drug liraglutide – previously known as GLP-1 receptor agonists in the Ozympic class – showed an 18% slower cognitive decline in the process. One year compared to those taking placebo.
However, the main goal of the experiment – to change the rate at which the brain metabolizes glucose – failed, which the researchers suggested may be due to the small size. The findings were released on Tuesday Alzheimer's Association International Conference in Philadelphia and have not yet been published in a peer-reviewed journal.
“We've known for some time in animal work that GLP-1 has a different activity in the brain,” said Dr. Maria CarrilloHe is the Alzheimer's Association's chief science officer and medical affairs leader, who is not involved with research. “This study really shows us the possibilities out there.”
According to a news release from the Alzheimer's Association, in addition to cognitive benefits, the drug was associated with a 50% reduction in volume in several brain areas. Those findings add to this hope Big tests It will be a success led by Olympic maker Novo Nordisk, Carrillo told .
In addition to diabetes and weight loss
They have GLP-1 drugs It exploded In recent years, it has been used for diabetes and weight loss, and has shown benefits for various health conditions, such as protecting the heart. KidneyReduction Sleep apnea And understandable Addiction.
Studies In animals, the drugs reduce neuroinflammation in the brain, prevent toxic proteins known as amyloid and tau, improve insulin resistance and enhance synaptic function, or the transmission of pressure between cells, he said. Dr. Paul EdisonA professor of neuroscience at Imperial College London led the experiment.
“This is the first study that looked at a relatively large number of patients to show that there is no neuroprotective effect on Alzheimer's disease,” Edison said.
The trial enrolled mostly people with mild Alzheimer's disease, as measured by a test known as the Mini-Mental State Test. scale That goes up to 30. Those who scored between 21 and 26 were considered to have mild Alzheimer's disease, and most of the participants in this study had a score of about 22, although some scored as low as 17, indicating mild Alzheimer's, Edison said. he said.
It does not involve trying to control any of the effects of the disease on patients with diabetes, which is itself a The cause of the accident For Alzheimer's.
Edison and his team conducted the experiment using a daily injection liraglutide sold under brand names Victoza For diabetes and Saxenda for weight loss, because it is similar to the GLP-1 hormone found in humans, and was on the market for diabetes when the study began a decade ago.
It was Ozempic that used an ingredient called semaglutide. approved in the US in 2017 for diabetes and then in the UK, and the equivalent for weight loss; WegoviIn the year Approved in the US in 2021. They are given as an injection once a week.
The GLP-1 class of drugs includes Eli Lilly Munjaro and Zepboden, which use the active ingredient tirzepatide, which mimics not only the GLP-1 hormone but also another GIP. And a snowball's worth of more companies are trying to develop. More powerful Medicines. Already, the current drugs have been introduced lack of As the companies try to keep up with the increasing demand.
Lilly already has a business in Alzheimer's; Getting accepted This month, Kisula, a treatment that cleans up amyloid plaques in the brain. But he has not reported any trials of GLP-1 drugs in Alzheimer's.
Lilly told : “It will continue to evaluate future options for tirzepatide, but has not announced a development plan for Alzheimer's at this time.”
Novo Nordisk, which sells liraglutide and semaglutide, has characterized the Alzheimer's trials as a long bet. The CEO is Lars Freygard Jørgensen He told . Last year, “Alzheimer's is one of the most difficult diseases to study, and there have been many failed drug development lists.”
“So I warned that it was more dangerous than anything we've ever tried,” he continued.
Novo Nordisk is conducting a trial using a daily semaglutide pill, with results as early as 2018. It is expected by the end of 2025. Oral form is already on the market under the brand name Rybelsus.
In the year When introducing the studies in 2020, the Danish pharmaceutical giant he said. It planned to enroll 3,700 people with early-onset Alzheimer's disease, about two years into the main treatment period.
The company said later Investor approach The decision to start phase III trials was based on data including real-world evidence studies showing a lower risk of dementia in humans with GLP-1 drugs, analysis of effects seen in other clinical trials, and studies showing that the drugs are associated with this. Improved memory function, reduced nerve inflammation and systemic anti-inflammatory effects.
At the beginning of this month, Evaluation Researchers at the University of Oxford found in US patient records that semaglutide was associated with a lower risk of cognitive problems and nicotine dependence. It was designed to evaluate whether the drug could have an adverse effect on the brain and instead evaluate the opposite.
GLP-1 may contain drugs Side effects, however, are mainly gastrointestinal problems such as nausea and vomiting. Those results were more common in a trial of liraglutide in Alzheimer's.
The research received partial funding from Novo Nordisk in addition to Alzheimer's Society UK and others.
Although more work needs to be done to prove that GLP-1 drugs can help people with Alzheimer's disease, Carrillo says the drugs can be used not only by themselves, but in combination. Recently approved Drugs that clear amyloid plaques from the brain.
“There's a lot of hope not only for a positive semaglutide test, but also for being able to combine that with an FDA-approved monoclonal antibody,” she says.