Does semaglutide help with Alzheimer's?

Semaglutide, a medication from Novo Nordisk used for diabetes and weight loss, is being tested in clinical trials to see if it could also help in the treatment of Alzheimer's disease. 

Researchers are recruiting participants for double-blind studies to investigate its impact on cognition. Rybelsus, another drug by Novo, is showing promise in mitigating dementia risk. 


Novo Nordisk is conducting a late-stage trial to evaluate Semaglutide's effectiveness as a disease-modifying agent for Alzheimer's. This marks a new phase in therapeutic development, focusing on improving cognition using drugs originally meant for controlling glucose levels. 


Novo Nordisk is committed to improving the lives of people with Alzheimer's and reducing the disease's risk.


Does semaglutide help with Alzheimer's?
Does semaglutide help with Alzheimer's?

What is Alzheimer's disease?


Alzheimer's disease is responsible for brain shrinkage, cell demise, and the development of dementia. Initial indications include memory loss and difficulties with language. As the disease advances, perplexity, fluctuations in mood, and alterations in behavior take place. 


Despite the absence of a cure, treatments do exist to alleviate symptoms and decelerate its progression. The continual pursuit of research endeavors to uncover enhanced treatments and preventive measures.


What is Semaglutide?


Semaglutide is a medication used to treat Type 2 diabetes and promote weight loss. It mimics the GLP-1 hormone to increase insulin production and regulate blood sugar levels. It has been approved for weight loss in overweight individuals with obesity-related conditions. 


The usual dose is 2.4 milligrams, administered weekly through self-injections. Studies show an average weight loss of 15%. However, concerns arise due to its off-label use and potential for shortages. Side effects include injection site pain, redness, and nausea, and weight regain may occur after stopping treatment.


Does semaglutide help with Alzheimer's?


Semaglutide has shown potential in helping with Alzheimer's disease. Novo Nordisk will begin phase 3 development in Alzheimer's disease with a 14 mg once-daily oral formulation of semaglutide. The decision was made after analyzing data from preclinical models and real-world evidence studies, as well as large cardiovascular outcomes trials. 


Phase 3 trials named evoke and evoke+ will assess the effectiveness and safety of oral semaglutide in individuals with early Alzheimer's disease. The main goal is to see how the CDR-SB score changes after 104 weeks of treatment.


The decision to start phase 3 trials was based on signs that neuroinflammation, which can impact thinking and function, was decreased. Studies in real-world settings have shown evidence that exposure to GLP-1 might reduce the risk of dementia. 


A post-hoc analysis of data from three big cardiovascular outcomes trials conducted by Novo Nordisk showed that GLP-1 treatment can significantly reduce the risk of dementia by 53%.


The evoke and evoke+ trials have started with 1,840 patients in each trial, totaling 3,680 patients, and are expected to finish in 2025. The results of these trials will provide more definitive evidence regarding the benefits of oral semaglutide in early Alzheimer’s disease.


Semaglutide alzheimer phase 3


Novo Nordisk will start phase 3 development for an oral 14 mg once-daily semaglutide for Alzheimer's disease. The decision was made after studying animals, real-world evidence, and data from large heart problem trials. Gram, planned to initiate in the first half of 2021, aims to involve approximately 3,700 people with early Alzheimer’s disease. The main treatment period in the trials is expected to last around two years.


The trials will assess the efficacy and safety of the oral semaglutide compared to a placebo. Semaglutide may have positive effects on Alzheimer's disease by improving memory and reducing neuroinflammation, potentially impacting cognition and function. The trials are considered high-risk due to the historical failure rate within Alzheimer’s clinical development.


What are 3 causes of Alzheimer's?


Alzheimer's disease is influenced by a combination of factors, which include:


Age-Related Changes in the Brain: 

Aging is the most significant known risk factor for Alzheimer's. As people age, there are various changes in the brain, such as atrophy (shrinking) of certain parts, inflammation, vascular damage, and the breakdown of energy production within cells. These changes may harm neurons and affect other types of brain cells, contributing to the development of Alzheimer's.


Genetic Factors: 

Genetics also play a crucial role in the development of Alzheimer's disease. Specific genetic risk factors, such as having one form of the apolipoprotein E (APOE) gene, can increase the likelihood of developing the disease. There are also rare cases where Alzheimer's is caused by changes in certain genes (such as APP, PSEN1, or PSEN2), leading to early-onset Alzheimer's.


Lifestyle and Environmental Factors: 

Research suggests that factors like cardiovascular health, diabetes, obesity, diet, physical activity, and cognitive engagement can influence the risk of cognitive decline and Alzheimer's. Managing these factors may help reduce the risk of developing Alzheimer's disease.


How does semaglutide affect the brain?


Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has shown promising effects on brain function, particularly in the context of Alzheimer's disease. 


The findings from the study suggest that semaglutide can significantly impact brain function by improving glucose metabolism and cognitive abilities in Alzheimer's disease through the SIRT1/GLUT4 signaling pathway. This provides a potential therapeutic strategy for treating Alzheimer's disease by targeting glucose metabolism dysfunction in the brain.


What diabetic drugs are used for Alzheimer's?

Diabetic drugs used for Alzheimer's disease include:

  • Empagliflozin: This drug has shown efficacy in reducing vascular damage and cognitive impairment in Alzheimer's disease when combined with type 2 diabetes.

  • Insulin: Intranasal insulin has been shown to improve memory and cognitive abilities in patients with mild cognitive impairment (MCI) and Alzheimer's disease.

  • Metformin: While not explicitly detailed in the provided sources, metformin is commonly referenced in literature as being explored for its potential benefits in Alzheimer's disease due to its effects on glucose metabolism and has been studied for its potential neuroprotective effects.

These drugs are part of a broader approach to repurpose antidiabetic medications to manage and potentially treat Alzheimer's disease by targeting shared pathophysiological features such as insulin resistance, inflammation, and vascular damage.

Semaglutide alzheimer's trial

Semaglutide alzheimer's trial


The EVOKE study is a significant clinical trial investigating the effects of semaglutide on individuals with early Alzheimer's disease. This study aims to determine whether semaglutide can have a positive impact on the condition. Participants in the trial are randomly assigned to receive either semaglutide or a placebo, and the study is expected to last for approximately 173 weeks (about 3 years and 4 months).


Semaglutide is known for its use in treating type 2 diabetes and works by improving blood sugar control when accompanied by diet and exercise. It's a long-acting analog of the hormone GLP-1, which stimulates insulin signaling². Increased insulin signaling is thought to potentially reduce neurodegeneration and improve glucose transport in the brain, which could be beneficial for Alzheimer's disease.

Conclusion

In the quest to conquer Alzheimer's disease, Novo Nordisk stands at the forefront, wielding Semaglutide as a beacon of hope. This new medication, originally for diabetes and weight loss, could now help with preserving and improving cognitive abilities. Phase 3 trials for oral Semaglutide are an important advancement in Alzheimer's research, offering new insights into this complex disease.



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