A GLP-1, Liraglutide, Shows Potential to Slow Down Alzheimer’s

On the theme of “Is there anything GLP-1s can’t do?” a new randomized controlled trial is coming at us from the Alzheimer’s Association International Conference. It showed promising signs that a GLP-1, liraglutide, might slow the progression of Alzheimer’s disease.

Liraglutide is used under the brand name Victoza to treat type 2 diabetes. At higher doses, Novo Nordisk has been selling it for obesity treatment as Saxenda. Because the patent expired, generic forms are beginning to come available.

Significant Limitation

Let’s be clear. this is an intriguing, but not definitive result. The study was small – a total of only 204 persons with mild to moderate Alzheimer’s randomized to liraglutide or placebo. Also, the study missed its primary endpoint. The researchers had hoped the drug would slow a measure of cerebral glucose metabolism in specific parts of the brain. It did not.

But it did meet important secondary endpoints. During this one-year study, it reduced the rate of structural changes in the brain and also slowed cognitive decline.

Protecting the Brain

Presenting author Paul Edison explained that this study builds on evidence from animal research for a neuroprotective effect of GLP-1 medicines:

“We think liraglutide is protecting the brain possibly by reducing inflammation, lowering insulin resistance and the toxic effects of Alzheimer’s biomarkers or improving how the brain’s nerve cells communicate.”

It’s worth noting that the injection doses in this study were the lower 1.8 mg doses used for treating type 2 diabetes. Not the 3.0 mg doses used for obesity. Also, two major trials of Rybelsus (oral semaglutide) for Alzheimer’s are underway. Results are due next year.

A Bigger Picture

This could become a big part of an emerging picture. We are seeing the emergence of ever more evidence that GLP-1 medicines can prevent many of the complications of obesity. The indication for preventing serious cardiovascular events, including death, is already approved. Indications for renal disease, sleep apnea, heart failure, and liver disease may be coming. Alzheimer’s might be one of those complications, too.

In time, it will dawn on people that treating obesity is more about preventing health problems than it is about losing weight.

Click here for information on the research presentation, including the research abstract. For further reporting, click here, here, and here.

Memories of Travel, painting by Gino Severini / WikiArt

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August 1, 2024