A recent study suggests that drugs commonly used to treat type 2 diabetes and obesity, known as GLP-1 receptor agonists, might also help prevent dementia, specifically Alzheimer’s disease. This finding opens a potential new avenue for a condition that currently has no cure and imposes significant burdens on patients, families, and healthcare systems worldwide.
Alzheimer’s disease is a progressive neurodegenerative disorder characterised by the abnormal accumulation of toxic proteins in the brain, which leads to widespread brain damage over time. As the disease advances, it causes a decline in cognitive functions, initially affecting daily activities and eventually leading to complete dependence on caregivers. This progression makes Alzheimer’s a devastating illness not just for those diagnosed but also for their families and caregivers who bear the emotional and financial burdens of care. The economic and societal costs of Alzheimer’s are substantial, and with no cure currently available, the impact of the disease continues to grow.
In the UK, dementia rates are on the rise, with Alzheimer’s and related dementias now being the leading cause of death after coronavirus. The condition places a significant burden on the National Health Service (NHS), with 25% of acute hospital beds occupied by dementia patients. These patients tend to have longer hospital stays compared to other individuals over the age of 65. As per NHS, 25% of people with dementia living at home were admitted to the hospital with potentially treatable conditions over a one-year period. This highlights the need for effective treatments that can manage symptoms and potentially slow the progression of the disease.
Promising result shows reducing brain shrinkage
Researchers at Imperial College London conducted a phase 2 clinical trial to investigate the potential benefits of GLP-1 receptor agonists in treating Alzheimer’s. The study involved more than 200 UK patients with mild to moderate Alzheimer’s disease, who were randomly assigned to receive either a daily injection of liraglutide, a GLP-1 receptor agonist, or a placebo. Over the course of one year, the study found that those who received liraglutide experienced an 18% slower decline in cognitive function compared to those who received the placebo. Additionally, MRI scans showed nearly 50% less volume loss in brain areas related to memory, language, and decision-making in the liraglutide group.
Although the primary goal of changing the cerebral glucose metabolic rate was not met, the secondary outcomes were significant. Liraglutide was well-tolerated, with fewer serious side effects reported compared to the placebo group. These promising results suggest that GLP-1 receptor agonists could be a potential treatment for Alzheimer’s disease, though larger phase 3 studies are needed to confirm these findings. The ongoing phase 3 EVOKE trial will further investigate the effects of a related GLP-1 receptor agonist, semaglutide, in early Alzheimer’s disease.
The study was funded by several organisations, including Alzheimer’s Society UK and the Alzheimer’s Drug Discovery Foundation. Experts emphasise the need for more extensive research to validate these preliminary findings.
Existingisting research shows that GLP-1s do not carry the risk of brain swelling and bleeding, side effects that have been linked to amyloid-targeting treatments like Leqembi and Kisunla. Patients who receive these amyloid-targeting treatments typically undergo routine MRIs to monitor for such side effects, which can be a significant burden. The fact that GLP-1s do not pose these risks makes them a potentially safer option for treating Alzheimer’s disease.
In the mid-stage trial, patients who received liraglutide most commonly experienced gastrointestinal side effects, such as nausea, which are associated with other GLP-1s. This may be one advantage of using GLP-1s to treat Alzheimer’s patients, especially since only a small proportion of these patients are currently receiving amyloid-targeting drugs. If approved for Alzheimer’s, GLP-1s could be administered widely with minimal monitoring, offering great potential for treating patients around the world.
The implications of these findings are significant. If GLP-1 receptor agonists can be confirmed as an effective treatment for Alzheimer’s disease, it could revolutionise the management of the disease, providing a new option that is both safer and easier to administer than current treatments. This would be a major breakthrough in the fight against Alzheimer’s, offering hope to millions of patients and their families. As research continues, the hope is that these findings will lead to new, effective treatments that can improve the lives of those affected by this devastating disease.
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