09/12/2025
What next for GLP-1 receptor agonists and dementia?
Novo Nordisk's EVOKE trial didn't meet its primary endpoint - semaglutide didn't slow cognitive decline in people with early Alzheimer's. But the results revealed something intriguing: reductions in biomarkers of neurodegeneration, inflammation, and tau protein. The drug does something to Alzheimer's biology - the question is when to use it.
Dr Ivan Koychev of DPUK, Associate Professor in Neuropsychiatry at Imperial College London, highlights the real opportunity: "The most encouraging evidence for GLP-1 therapies comes from epidemiology, showing reduced dementia incidence in people using these drugs. That suggests a preventive signal rather than an effect in treating established disease."
In other words, EVOKE asked: can we slow decline once symptoms appear? Answer: no. But the more important question might be: can we prevent dementia before symptoms start? That remains wide open.
As Ivan notes: "Science moves forward when we learn from every result, positive or negative, and keeps our focus on what matters most: better, evidence-based options for patients and families."
This is why rigorous trials - even those that don't meet their endpoints - are essential. They refine our hypotheses, clarify where to focus next, and remind us that timing of intervention may be as crucial as the intervention itself.
Worth a read 👇 https://zurl.co/ZFZpM
Novo Nordisk A/S left open the door for additional work on its pill version of Ozempic for Alzheimer’s disease after a pair of failed trials, saying that patients showed a biological response in a handful of areas despite getting no cognitive improvement.