LONDON, May 8 (Reuters) – Diabetes drugs that also promote weight loss such as Novo Nordisk’s ( NOVOb.CO ) Ozempic, which is becoming the darling of celebrities and investors, are being studied to address some of the most difficult to treat brain diseases. , including Alzheimer’s disease.
Diabetes regimens, from Ozempic to old mainstays like insulin and metformin, appear to address many different aspects of the metabolic system involved in Alzheimer’s disease, including a protein called amyloid and inflammation. , the researchers said.
The hope is that improving glucose utilization and reducing inflammation throughout the body — including the brain — could slow the progression of debilitating diseases like Alzheimer’s and Parkinson’s.
Several scientists interviewed by Reuters pointed out mounting research supporting the evaluation of diabetes drugs against neurodegenerative diseases.
It was years ago and success was uncertain. But interest has been fueled by recent positive data on Alzheimer’s drugs being developed by Eisai Co Ltd ( 4523.T ) with partner Biogen ( BIIB.O ) and by Eli Lilly and Co ( LLY.N ) showing that the -removal of sticky amyloid plaques that accumulate in the brain can slow the decline in cognition caused by the deadly, debilitating disease.
Those successes followed decades of futility that left many questioning the validity of the amyloid theory behind most experimental Alzheimer’s drugs.
Dr. Suzanne Craft, professor of gerontology and geriatric medicine at Wake Forest University School of Medicine, gave a keynote address at an influential Alzheimer’s scientific meeting late last year about the need to test treatments such as diabetes drugs to further reduce the progression of Alzheimer’s.
He says he has since been approached by pharmaceutical companies at an increasing rate, and is currently running an Alzheimer’s trial testing intranasal insulin in combination with another diabetes drug.
Diabetes treatments could amplify the clinical benefit of anti-amyloid drugs, and potentially lead to complete stabilization or even some recovery in Alzheimer’s patients, Craft said.
“This is what these agents do, and what insulin does. It plays a role in regeneration. And that’s what needs to happen. Because of its role in modulating immune function, it can prevent amyloid from in constant accumulation,” Craft surmised.
Unlike older off-patent drugs like metformin, there is a commercial incentive to try newer treatments like GLP-1 agonists, a rapidly expanding class now led by Ozempic, known as semaglutide, and Lilly’s Mounjaro, with other players working on a dozen potential. new treatments.
Four companies with GLP-1 drugs, including two larger drugmakers, say they are watching the results of trials testing Novo’s drug in Alzheimer’s.
Ivan Koychev, consultant neuropsychiatrist for Oxford University Hospitals NHS Foundation Trust, is running a trial of semaglutide with the aim of stopping the earliest changes in the brain of people at risk of developing Alzheimer’s.
GLP-1s are his main focus, he said, because there is “good epidemiological evidence that they are associated with a lower risk for dementia but run a lower risk of serious side effects relative to amyloid clearance therapies.”
Anti-amyloid therapies carry the risk of dangerous brain inflammation.
Any success can lead to a big payoff. Dementia affects more than 55 million people worldwide and the market for Alzheimer’s drugs is expected to grow to $9.4 billion by 2028 and for Parkinson’s to $6.6 billion, according to pharmaceutical data provider Citeline.
Despite their potential against Alzheimer’s, early research has yielded mixed results, warns Hannah Churchill, research communications manager at the Alzheimer’s Society.
“It’s definitely worth pursuing, but it’s hard to know if it’s a front-runner at this stage,” he said.
EYE ON NOVO
Novo in 2021 began two trials testing semaglutide – also sold for weight loss as Wegovy – in thousands of patients with early Alzheimer’s. Results are expected by 2025 as it takes many years to show an effect in progressive conditions.
The Danish drugmaker declined to be interviewed for this story.
“Everyone is waiting to see what can be shown. Investors want someone else to take the risk on Alzheimer’s first, like Novo,” said Ted Dawson, professor of neurology at John Hopkins University and co-founder of Neuraly, with an experimental GLP -1 drug.
Lilly told Reuters it was watching that trial closely. Pfizer ( PFE.N ), which has GLP-1 experiments, is also targeting Novo.
Smaller companies, including US-based Neuraly and Denmark-based Kariya Pharmaceuticals, have said they are testing experimental GLP-1 drugs against Parkinson’s and may consider moving to Alzheimer’s if Novo’s trial pays off. .
Parkinson’s trials tend to take less time and may require fewer patients because it is easier to assess the effect on motor function characteristics of the disease to understand whether treatments are benefiting the brain.
Wassilios Meissner, head of the neurology department for neurodegenerative diseases at University Hospital Bordeaux, is involved in a mid-stage Parkinson’s trial trial of Sanofi’s ( SASY.PA ) GLP-1 lixisenatide.
Meissner said postmortem research on the brains of both Alzheimer’s and Parkinson’s patients shows that insulin signaling is impaired.
“That means these pathways that provide support to the brain are dysfunctional,” he said. “So people started to ask if there might be an interest for anti-diabetics for the treatment of these disorders.”
Natalie Grover reporting in London; Additional reporting by Mike Erman in New York and Deena Beasley in Los Angeles; Editing by Caroline Humer and Bill Berkrot
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