Semaglutide, principle of Ozempic medicines and Wegsis now being tested by Danish drugmaker Novo Nordisk for the treatment of Alzheimer’s disease. If the results, which should be released in 2025, are positive, the drug could be a new alternative to restore brain insulin function and delay cognitive impairment.
The drug is an analogue of GLP-1, a hormone naturally produced by the body. Among its functions is to stimulate the production of insulin, which makes the drug used in the treatment of type 2 diabetes. Now, researchers are suspicious that this action can prevent or delay the effects of Alzheimer’s.
Studies show that GLP-1 receptors, supporting brain functions, can be protagonists when it comes to neurodegeneration. Involved in cognitive processes, in the transmission of synapses in the hippocampus and in cell death, such receptors are targets in the development of new drugs.
Alzheimer’s is characterized by the accumulation of beta-amyloid and tau proteins in the brain mass, forming plaques that prevent the normal flow of synapses. The disease also causes an inflammation process in the central nervous system that causes the lower action of several hormones, including insulin.
The link between the disease and insulin resistance has led to Alzheimer’s being dubbed Type 3 diabetes in the past. Today, however, this view is considered simplistic. The disease is the result of a slow process linked to aging, dependent on environmental and educational factors.
João Salles, endocrinologist and professor at the Faculty of Medical Sciences of Santa Casa de São Paulo, says that treatment with semaglutide should target the process that decreases the action of insulin.
The drug’s anti-inflammatory effects have already been seen in preliminary studies. If the results are positive, for the first time there will be a drug that acts on the inflammation of neurons. For the specialist, it is even possible that the substance delays the evolution of the disease, in addition to acting in prevention.
As the drug has already been approved for use in therapies against diabetes and obesity, the two clinical trials will begin in phase 3. The researchers’ expectations is that almost 2 thousand patients are recruited in the early stages of Alzheimer’s in each of the works. “This is a study that we call a hypothesis generator”, says Salles.
Organized into two groups, the volunteers will receive doses of 14 mg of the drug or a placebo for just over three years. The expectation is that the first results will be published in September 2025, and that the research will continue until the end of the following year, October 2026.
Another problem with Alzheimer’s treatment, according to the expert, is time. Evidence shows that interventions are most effective when the person experiences the onset of the disease. Early patients do not have classic symptoms, and the diagnosis needs to be given through biomarker tests, such as amyloid PET. Therefore, studies are still recruiting volunteers.
“It is very common that, over time, you discover other applications for drugs that were released at a time”, says João Oliveira, researcher and professor at UFPE (Federal University of Pernambuco).
Semaglutide will also be tested to evaluate patients with Parkinson’s in a phase study 2 registered in 2018 by Oslo University Hospitalbut it hasn’t started yet.
Among the substances of the same class, dulaglutide is another drug used in the treatment of diabetes that has brought cognitive benefits to users. During Clinical studies with nearly 10,000 participants, it reduced the risk of cognitive decline by 14% in patients who used it for about five years compared to those who received a placebo. The results of the study, sponsored by pharmaceutical Eli Lilly, were published in 2020 in the scientific journal The Lancet.
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