Semaglutide, the active ingredient in Ozempic and Wigovy, appears to reduce the risk of Alzheimer's disease in people with type 2 diabetes, according to a study published Thursday in the journal Alzheimer's & Dementia.
This study adds to the evidence that GLP-1 drugs (a class of drugs that also includes Mounjaro and Zepbound) can benefit the brain.
In July, a study presented at the Alzheimer's Association International Conference found that a GLP-1 drug similar to semaglutide (called liraglutide) was associated with delayed cognitive decline in patients with mild Alzheimer's disease who did not have diabetes. It turned out that there was. In another study, Published in Augustfound that semaglutide appeared to reduce the risk of dementia in patients with type 2 diabetes. Type 2 diabetes is a risk factor for dementia and Alzheimer's disease.
Novo Nordisk, which makes Ozempic and Wigovy, is conducting two Phase 3 clinical trials comparing semaglutide with a placebo in more than 3,000 patients with mild cognitive impairment or early Alzheimer's disease. The test results are expected to be announced sometime next year.
If these trial results are positive, semaglutide “could be a game changer, adding a whole new treatment option that wasn't previously in the toolkit,” said Stephen Sulloway, professor of neurology at Warren Alpert Medical School. said the doctor. Brown University in Rhode Island.
“If this actually worked, it would be a huge deal,” Sulloway said.
What was the effect of semaglutide?
The new study compared semaglutide to seven other diabetes drugs, including metformin, insulin, and older GLP-1 drugs, including liraglutide.
Researchers looked at three years of medical records from more than 1 million people with type 2 diabetes who were 60 years old and older and had just started taking either drug. Participants also had to have at least one other underlying medical condition, such as obesity, high blood pressure, or heart disease, and had not used diabetes medications in the past six months.
The study found that patients prescribed semaglutide had a significantly lower risk of Alzheimer's disease than those who took one of seven other diabetes drugs. The results were consistent regardless of gender, age, and weight.
The biggest differences were seen when comparing patients who took semaglutide to those who took insulin. A study found that patients who took semaglutide had a 70% lower risk of Alzheimer's disease.
Rong Xu, the study's senior author and director of the Center for Artificial Intelligence Drug Discovery at Case Western Reserve University School of Medicine in Ohio, also said semaglutide carries significantly lower risks than older GLP-1 drugs, including liraglutide. A discovery that surprised her.
The highest dose of Ozempic is 2 milligrams. Wegovy is available in a higher dose of 2.4 mg. Patients who participated in the semaglutide study were prescribed Ozempic, Xu said.
“Would we see even stronger effects if we had a higher-dose dosage form?” Xu said.
How can GLP-1 help?
There is no cure for Alzheimer's disease.
The Food and Drug Administration has approved two treatments, Biogen's Requembi and Lilly's Kisunra, that slightly slow the progression of the disease by targeting the amyloid plaques in the brain that are characteristic of the disease. However, they are expensive and can have serious side effects, such as brain swelling and cerebral hemorrhage.
If clinical trials find that semaglutide reduces the risk of disease, it could become a first-line preventive treatment.
A Novo Nordisk spokesperson said in a statement that the company “welcomes independent research investigating the safety, efficacy and clinical utility of our products.”
Sulloway said researchers still don't know exactly how and to what extent semaglutide protects the brain from Alzheimer's disease.
However, studies have shown the drug to have positive effects on inflammation, diabetes, obesity and heart disease, all of which are risk factors for dementia and Alzheimer's disease, he said.
“Obviously, everything they've been working on in addition to weight loss,” Sulloway said. “It has a number of positive effects, including lowering the incidence of heart attacks, controlling diabetes, controlling strokes, and controlling kidney disease.”
Donna Wilcock, editor-in-chief of Alzheimer's & Dementia and professor of neurology at Indiana University School of Medicine, said there is growing interest in the potential for GLP-1 drugs to treat Alzheimer's disease.
“They improve the health of blood vessels, which we know have an impact not only in Alzheimer's disease, but also in cerebral small vessel disease, which is a common comorbidity with Alzheimer's disease and other neurodegenerative processes. '' Wilcock said. “It is unclear from this study whether the effect is independent of its effect on type 2 diabetes, which is a risk factor for dementia, or whether it has a secondary effect on improving type 2 diabetes.”
Dr. Alberto Espey, a neurologist at the University of Cincinnati College of Medicine, stressed that more research is still needed to determine whether the drug actually has an effect on Alzheimer's disease.
Alzheimer's disease is thought to be a multi-disease condition, so one treatment won't work for everyone, Espey said.
Additionally, early studies suggested that statins, nonsteroidal anti-inflammatory drugs, and insulin had a positive effect on Alzheimer's disease, but none of these treatments worked.
“Like statins, NSAIDs, and insulin, we should be cautious about claiming that semaglutide can treat or prevent Alzheimer's disease based solely on this study,” Espey said.