When you hear the phrase Ozempic, weight reduction instantly involves thoughts. The drug—a part of a household of remedies known as GLP-1 agonists—took the medical world (and web) by storm for serving to folks handle diabetes, decrease the danger of coronary heart illness, and quickly shed pounds.
The medication may shield the mind in opposition to dementia. In a scientific trial together with over 200 folks with delicate Alzheimer’s illness, a every day injection of a GLP-1 drug for one 12 months slowed cognitive decline. When challenged with a battery of assessments assessing reminiscence, language expertise, and decision-making, contributors who took the drug remained sharper for longer than those that took a placebo—an injection that regarded the identical however wasn’t purposeful.
The outcomes are the most recent from the Evaluating Liraglutide in Alzheimer’s Disease (ELAD) study led by Dr. Paul Edison at Imperial School London. Launched in 2014, the research was primarily based on years of analysis in mice displaying liraglutide—a GLP-1 drug already authorized for weight reduction and diabetes administration in the USA—additionally protects the mind.
In Alzheimer’s illness, neurons die off and the mind step by step loses quantity. Within the trial, Liraglutide slowed the method down, leading to roughly 50 p.c 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 remedies in numerous phases of growth that gradual or could probably forestall cognitive decline attributable to Alzheimer’s illness,” said 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 have been introduced final month on the Alzheimer’s Association International Conference.
Again to Fundamentals
The hunt for an Alzheimer’s illness therapy is affected by failures. Most remedies aim to tackle toxic protein clumps that construct up contained in the mind. It’s thought that breaking them up might forestall neurons from withering away.
A number of have had restricted success. Last month, the US Meals and Drug Administration (FDA) authorized a drug that breaks down the clumps in folks already experiencing signs at an early stage of the illness. A number of weeks later, the European Medicines Company refused to approve one other drug that additionally targets the clumps, saying the consequences of delaying cognitive decline didn’t stability the danger of great unintended effects, together with mind swelling and bleeding.
Different scientists have regarded elsewhere—particularly, diabetes. Insulin helps keep mind well being, and Kind 2 diabetes is a threat issue for creating Alzheimer’s illness. Slightly than straight breaking down protein clumps within the mind, may 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 considering you’re full. In different phrases, the medication don’t solely affect the intestine—they also change brain functions.
In a mouse model of Alzheimer’s, every day injections of liraglutide for eight weeks prevented reminiscence issues. Their neurons additionally thrived. Synapses—the junctions connecting mind cells—have 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 p.c, and irritation dropped.
Liraglutide didn’t simply work on neurons. Another study, additionally in an Alzheimer’s mouse mannequin, discovered it quickly tweaked the metabolism of a specific form 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’ capacity to help neurons, permitting the neurons to flourish and hook up with others. The mind additionally made higher use of sugar—its major gasoline—permitting it to present delivery to new neurons in a area vital for reminiscence.
However as the sphere frustratingly is aware of, mice aren’t folks. Many promising remedies 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 delicate Alzheimer’s. Referred to as ELAD, the research was to be randomized and double-blind—the gold normal 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, day-after-day for a 12 months. Earlier than the trial, every individual had an MRI scan to map their mind’s construction and quantity. Different scans recorded mind metabolism, and a battery of reminiscence assessments detailed cognition. These assessments have been repeated on the finish, with security checkups in between, in case of unintended 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 assessments of reminiscence, comprehension, language, and spatial navigation.
Individuals who took liraglutide had practically 50 p.c 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,” said 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 p.c slower decline than those that took the placebo. Nonetheless, the drug didn’t have an effect on mind metabolism.
Unwanted side effects have been comparatively delicate. The most typical was nausea. Extra severe ones, not specified, occurred in 18 sufferers however weren’t seemingly associated to the therapy in keeping with Edison.
To be clear, the group introduced the outcomes at a convention, and so they haven’t but been formally vetted by different specialists within the subject. However they add to accumulating proof that GLP-1 medication gradual cognitive decline. A Swedish study in June performed a simulated trial in folks with Kind 2 diabetes given GLP-1 or two different forms of medication and assessed their cognition afterward. Utilizing well being information data from over 88,000 contributors adopted over 4 years, GLP-1 medication have been higher than the 2 different diabetes medication at maintaining the danger of dementia at bay.
We don’t but understand how liraglutide protects the mind. Primarily based on research in mice, it seemingly works a number of methods, equivalent 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 clinical 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 authorized for different circumstances has the benefit of offering information and expertise from earlier analysis and sensible use—so we already know lots about real-world effectiveness in different illnesses and unintended effects,” said Carrillo.
Picture Credit score: Maxim Berg / Unsplash
