If you happen to hear the phrase Ozempic, weight reduction instantly involves thoughts. The drug—a part of a household of therapies known as GLP-1 agonists—took the medical world (and web) by storm for serving to folks handle diabetes, decrease the chance of coronary heart illness, and quickly drop some pounds.
The medication might also shield the mind in opposition to dementia. In a scientific trial together with over 200 folks with gentle Alzheimer’s illness, a each day injection of a GLP-1 drug for one yr slowed cognitive decline. When challenged with a battery of checks assessing reminiscence, language expertise, and decision-making, members who took the drug remained sharper for longer than those that took a placebo—an injection that regarded the identical however wasn’t useful.
The outcomes are the most recent from the Evaluating Liraglutide in Alzheimer’s Illness (ELAD) research led by Dr. Paul Edison at Imperial School London. Launched in 2014, the research was based mostly on years of analysis in mice exhibiting liraglutide—a GLP-1 drug already accepted for weight reduction and diabetes administration in the US—additionally protects the mind.
In Alzheimer’s illness, neurons die off and the mind regularly loses quantity. Within the trial, Liraglutide slowed the method down, leading to roughly 50 % much less quantity misplaced in a number of areas of the mind associated to reminiscence in comparison with a placebo.
“We’re in an period of unprecedented promise, with new therapies in varied levels of growth that gradual or could presumably stop cognitive decline as a consequence of Alzheimer’s illness,” stated Dr. Maria C. Carrillo, Alzheimer’s Affiliation chief science officer and medical affairs lead, in a press launch. “This analysis supplies hope that extra choices for altering the course of the illness are on the horizon.”
The outcomes had been offered final month on the Alzheimer’s Affiliation Worldwide Convention.
Again to Fundamentals
The search for an Alzheimer’s illness remedy is affected by failures. Most therapies intention to deal with poisonous protein clumps that construct up contained in the mind. It’s thought that breaking them up may stop neurons from withering away.
A couple of have had restricted success. Final month, the US Meals and Drug Administration (FDA) accepted a drug that breaks down the clumps in folks already experiencing signs at an early stage of the illness. A couple of weeks later, the European Medicines Company refused to approve one other drug that additionally targets the clumps, saying the results of delaying cognitive decline didn’t stability the chance of significant negative effects, together with mind swelling and bleeding.
Different scientists have regarded elsewhere—particularly, diabetes. Insulin helps preserve mind well being, and Sort 2 diabetes is a threat issue for creating Alzheimer’s illness. Slightly than straight breaking down protein clumps within the mind, would possibly we shield the mind by tweaking the physique’s metabolism?
Enter GLP-1 medication. These mimic hormones launched by the abdomen after a satisfying meal, tricking the mind into pondering you’re full. In different phrases, the medication don’t solely affect the intestine—additionally they change mind features.
In a mouse mannequin of Alzheimer’s, each day injections of liraglutide for eight weeks prevented reminiscence issues. Their neurons additionally thrived. Synapses—the junctions connecting mind cells—had been nonetheless capable of quickly kind neural networks in areas particularly broken by the illness. Surprisingly, poisonous protein clumps additionally declined by as much as 50 %, and irritation dropped.
Liraglutide didn’t simply work on neurons. One other research, additionally in an Alzheimer’s mouse mannequin, discovered it quickly tweaked the metabolism of a specific type of star-shaped mind cell that helps neurons. These cells don’t kind neural networks, however they do assist present vitality. In Alzheimer’s, they cease functioning usually, however liraglutide reversed the decline. In mice, the drug improved the cells’ means to assist neurons, permitting the neurons to flourish and hook up with others. The mind additionally made higher use of sugar—its main gas—permitting it to offer start to new neurons in a area vital for reminiscence.
However as the sector frustratingly is aware of, mice will not be folks. Many promising therapies in mice have failed in scientific research, incomes these endeavors the nickname “graveyard of desires.”
The Trial
Edison took on the duty of extending the analysis from mice to people. In 2019, he and his colleagues detailed plans for a scientific trial to gauge liraglutide’s results in folks with gentle Alzheimer’s. Known as ELAD, the research was to be randomized and double-blind—the gold commonplace in scientific trials. Right here, neither physician nor affected person is aware of who’s getting liraglutide or the placebo.
They recruited 204 folks to obtain injections, both liraglutide or placebo, daily for a yr. Earlier than the trial, every particular person had an MRI scan to map their mind’s construction and quantity. Different scans recorded mind metabolism, and a battery of reminiscence checks detailed cognition. These checks had been repeated on the finish, with security checkups in between, in case of negative effects.
The research had a number of objectives. One was to see if liraglutide elevated the mind’s metabolism in areas closely impacted by Alzheimer’s—these associated to studying, reminiscence, and decision-making. One other examined mind quantity, which decreases because the illness progresses. The final evaluated cognitive checks of reminiscence, comprehension, language, and spatial navigation.
Individuals who took liraglutide had practically 50 % much less mind quantity loss, particularly in areas related to reasoning and studying. “The slower lack of mind quantity suggests liraglutide protects the mind, very similar to statins shield the center,” stated Dr. Edison.
Liraglutide additionally boosted cognition. Evaluating scores from earlier than the trial, at its midpoint, and on the finish, those that acquired the drug had an 18 % slower decline than those that took the placebo. Nonetheless, the drug didn’t have an effect on mind metabolism.
Unintended effects had been comparatively gentle. The most typical was nausea. Extra critical ones, not specified, occurred in 18 sufferers however weren’t probably associated to the remedy in accordance with Edison.
To be clear, the group offered the outcomes at a convention, and so they haven’t but been formally vetted by different specialists within the discipline. However they add to accumulating proof that GLP-1 medication gradual cognitive decline. A Swedish research in June performed a simulated trial in folks with Sort 2 diabetes given GLP-1 or two different kinds of medication and assessed their cognition afterward. Utilizing well being knowledge data from over 88,000 members adopted over 4 years, GLP-1 medication had been higher than the 2 different diabetes medication at conserving the chance of dementia at bay.
We don’t but know the way liraglutide protects the mind. Based mostly on research in mice, it probably works a number of methods, similar to decreasing irritation, clearing poisonous protein clumps, and enhancing talk between neurons, Edison stated.
However the thought is gaining steam. EVOKE Plus, a late stage scientific trial of semaglutide—the chemical in Ozempic—is ongoing. The research will take about three and a half years, with an estimated enrollment of 1,840 folks with early Alzheimer’s illness. It’s set to conclude in late 2026.
“Repurposing medication already accepted for different circumstances has the benefit of offering knowledge and expertise from earlier analysis and sensible use—so we already know rather a lot about real-world effectiveness in different ailments and negative effects,” stated Carrillo.
Picture Credit score: Maxim Berg / Unsplash
