Topline
A weight loss and diabetes drug in the same class as blockbuster medicines like Ozempic and Wegovy may help stave off dementia, according to new data reported Tuesday, adding to mounting evidence the popular drugs can help treat a diverse array of conditions.
Liraglutide may help protect the brain, researchers found.
Key Facts
Liraglutide appears to slow cognitive decline by protecting the brain, according to data from a mid-stage clinical trial revealed at the Alzheimer’s Association International Conference in Philadelphia.
Liraglutide, sold under brand names Saxenda and Victoza by Ozempic maker Novo Nordisk, belongs to a class of drug known as a glucagon-like peptide receptor agonist, often just GLP-1 or GLP-1RA, that mimics a gut hormone involved in regulating hunger and blood sugar.
The study, which builds on work in animals suggesting liraglutide cuts the amount of amyloid plaque in the brain that is thought to cause Alzheimer’s disease in humans, assessed more than 200 Alzheimer’s patients taking the drug or a placebo over the course of a year for changes to cognitive function and their brains based on regular testing and MRI scans.
The patients receiving liraglutide injections had an 18% slower decline in cognitive function in a year compared to the placebo group, the researchers found, as well as nearly 50% less volume loss in several areas of the brain related to memory, language, decision-making and learning, key functions often affected by Alzheimer’s.
“The slower loss of brain volume suggests liraglutide protects the brain, much like statins protect the heart,” said the trial’s lead researcher Paul Edison, a professor of neuroscience and medicine at Imperial College London.
Though further research will be needed to investigate whether, how and to what extent liraglutide can be used to combat Alzheimer’s and dementia, Edison said the drug could potentially work by reducing inflammation in the brain, lowering resistance to insulin, improving how brain cells communicate and lowering the toxic effects of proteins that signal Alzheimer’s like amyloid.
Could Other Glp-1 Drugs Like Ozempic And Wegovy Help Treat Alzheimer’s?
It’s not known whether more recent GLP-1 drugs like semaglutide and tirzepatide—generic names for Ozempic, Wegovy, Mounjaro and Zepbound—will have an effect on conditions like Alzheimer’s. As both belong to the same class of drug as liraglutide and act in similar ways by targeting the GLP-1 system, findings for one drug do give an indication for what may happen with the other, though this would need to be tested. If findings for weight loss hold true—both induce far more weight loss than liraglutide—it is possible they could be even more effective at targeting dementia. As with other GLP-1 therapies, side effects could prove problematic, though researchers did not report major issues with this trial.
Crucial Quote
“Repurposing drugs already approved for other conditions has the advantage of providing data and experience from previous research and practical use—so we already know a lot about real-world effectiveness in other diseases and side effects,” said Maria Carrillo, chief science officer and medical affairs lead for Alzheimer’s Association, a nonprofit that funds research into drugs that could treat the disease. She added: “We are in an era of unprecedented promise, with new treatments in various stages of development that slow or may possibly prevent cognitive decline due to Alzheimer’s disease.”
What To Watch For
Clinical trials take years to complete and any label expansion to include Alzheimer’s treatment will still be years away even if everything goes to plan and a link is demonstrated. Assessing the disease, particularly in its early stages where cognitive symptoms may go unnoticed, and figuring out ways to assess whether treatments have worked have been an issue with other modern Alzheimer’s treatments and could be barriers to rolling out any treatments if they are approved. Late-stage trials are already underway to see whether other GLP-1s could help with Alzheimer’s, such as the Evoke trial testing semaglutide in a study involving more than 1,800 people with early-stage Alzheimer’s.
Tangent
There is growing pressure for insurers, employers and healthcare systems to cover GLP-1 drugs though concerns over the drugs’ cost has raised concerns over the viability of existing funding mechanisms to enable access. Persistent shortages are also a concern, both for ensuring access to new patients wanting to use them for weight loss, ensuring supplies for existing patients and for those using them to treat diabetes. This issue is expected to become more pressing as the drugs become more popular for weight loss and as they are shown to benefit more conditions like cardiovascular problems.
Big Number
$13 billion. That’s how much Bloomberg Intelligence analysts predict the Alzheimer’s drug market could be worth by 2030, though this figure is largely geared towards new monoclonal antibody therapies specifically designed and approved for that condition like aducanumab, lecanemab and donanemab. Estimates for the GLP-1 market dwarf that for Alzheimer’s and are already as high as $150 billion by the early 2030s.
Further Reading
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