The popular anti-obesity drug has failed in long-awaited trials to treat neurological diseases such as Alzheimer’s and Parkinson’s.
Peptide-like receptor agonists glucagon type 1 (GLP-1), used in medicines such as semaglutiderevolutionized the treatment of obesity, diabetes and other pathologies frequent.
According to a study published in April in JAMA Neurology, which ZAP reported at the time, these medications could also treat Alzheimer’s disease.
But these hopes have just suffered a severe setback.
According to Novo Nordisk this Monday, the long-awaited results of two large trials with the oral formulation of semaglutide in people with Alzheimer’s did not show any slowdown of disease progression compared to placebo.
The medicine However, some markers of the disease improved not specified, details the statement from the Danish pharmaceutical company, which sponsored the trials.
Although GLP-1 drugs gave signs of being able to prevent diseases neurodegenerative diseases, many researchers considered unlikely that these medicines would help when the disease is already present.
“We had a responsibility to explore the potential of semaglutide, despite the low probability of success», explains Martin Holst Lange, scientific director of Novo Nordisk, in the statement.
The tests, designated evoke e evoke+were the largest and longest studies ever carried out with GLP-1 drugs in a neurodegenerative disease, involving approximately 3800 people in the early stages of Alzheimer’sfollowed for two years.
Both trials randomized participants to receive a daily dose of up to 14 milligrams semaglutide or a placebo. evoke+ included a greater number of people with evidence, on imaging tests, of cerebrovascular disease, which often coexists with Alzheimer’s disease.
But, after no effect of semaglutide is observed on the Clinical Dementia Rating/Sum of Boxes (CDR-SB) scale, a widely used measure of cognitive and functional function in Alzheimer’s trials, the company canceled additional trials that were already planned.
Novo Nordisk intends to present more detailed results early next month at the Clinical Trials on Alzheimer’s Disease meeting in San Diego.
According to , the trials were inspired, in part, by signs that GLP-1 drugs could prevent neurodegeneration.
These medicines have demonstrated strong protective effects on neurons in animal studies, and people taking them to treat diabetes showed a reduced incidence of Parkinson’s or Alzheimer’s disease, including when compared with patients taking other antidiabetic treatments.
Already stop a neurodegenerative process after it has started It’s another story. Earlier this year, a clinical trial with exenatide, another drug in the GLP-1 class, did not show any slowdown in progression in Parkinson’s patients, despite encouraging results in an early phase human study.
Daniel Drucker, endocrinology researcher and GLP-1 expert at the University of Toronto (UToronto), who was not involved in the trial, thought that these drugs could have a better chance of helping patients com Alzheimer.
It is known that they interfere with several processes involved in the disease. “These medicines improve insulin resistance in the brain and neuronal survival. Reduce plaques in some animal studies. Reduce brain inflammation. They communicated with receptors on neurons,” he says.
O safety record of this class of drugs It also motivated the test, the researchers say: at least, it was unlikely to cause serious damage. «I think it’s excellent that they took this risk in a neurodegenerative disease, and in such a definitive way», he comments Lorraine KaliaParkinson’s disease researcher, also at UToronto.
Despite the disappointing results, Drucker believes that the more detailed data, yet to be released, could lead to important conclusions, and he is curious to know whether additional analyzes will show that semaglutide may have anti-inflammatory effects on the brain.
For now, the hope that anti-obesity drugs could curb degenerative diseases has suffered a serious blow. But, as the Portuguese saying goes, hope is the last to die.
