Daijiworld Media Network - London
London, Dec 13: Recent clinical trials of Novo Nordisk’s blockbuster GLP-1 drug semaglutide for Alzheimer’s disease may have failed to show cognitive benefits, but experts say the outcome highlights a significant shift in how the brain-wasting disorder is being approached — moving away from single-target therapies towards a complex, multi-pathway strategy, similar to advances seen in cancer treatment.
At present, only two drugs — Eli Lilly’s Kisunla and Leqembi, developed by Eisai and Biogen — are approved to slow Alzheimer’s progression. Both target toxic amyloid plaques in the brain and have shown about a 30 per cent delay in disease progression. However, scientists are increasingly recognising that amyloid alone may not fully explain the disease.
Globally, more than 55 million people live with dementia, around 60 per cent of whom have Alzheimer’s, marked by the buildup of amyloid and tau proteins. Experts say ageing-related diseases often require combination therapies.
“All the diseases of aging require combination therapy. Just targeting one pathway isn’t going to be enough,” said Howard Fillit of the Alzheimer’s Drug Discovery Foundation.
New blood and genetic tests are improving the detection of Alzheimer’s biomarkers, though diagnosis still often relies on spinal taps or costly PET scans. Research suggests that treatment outcomes vary across patients, with factors such as sex, tau levels and ethnicity influencing responses to therapy.
Drawing parallels with oncology, where treatment has evolved from broad chemotherapy to targeted and personalised medicines, experts believe Alzheimer’s research is entering a similar phase. “It’s like oncology 20 years ago — super exciting,” said David Watson, CEO of the Alzheimer’s Research and Treatment Center.
While oral semaglutide showed no benefit in early Alzheimer’s, Novo Nordisk is expected to release detailed trial data, including subgroup analyses, which may guide future research. Eli Lilly, which markets GLP-1 drugs Mounjaro and Zepbound, continues to monitor the drug class’s potential role, though its current focus is on addiction-related brain health.
Meanwhile, new therapies targeting tau proteins, mixed dementia conditions and drugs capable of crossing the blood-brain barrier are in advanced stages of development. Companies such as Roche, Biogen and Annovis Bio are testing next-generation treatments that act on multiple disease pathways, raising hopes for more effective and personalised Alzheimer’s care in the years ahead.