New reviews counsel diabetes weight reduction medicine might cut back Alzheimer’s threat

Medicine initially developed to deal with sort 2 diabetes, notably GLP-1 receptor agonists corresponding to semaglutide (offered as Ozempic and Wegovy), at the moment are drawing elevated consideration for his or her potential to guard mind well being. Two current research and an editorial in JAMA Neurology counsel these drugs might assist cut back the danger of dementia.

Dementia, together with Alzheimer’s and associated issues, is among the fastest-growing public well being challenges. It impacts almost 7 million People at present and is projected to double by 2060. Whereas newly accredited Alzheimer’s medicine like lecanemab and aducanumab have garnered consideration, issues over their effectiveness and security stay. This has intensified curiosity in repurposing current medicine which might be already broadly used and well-tolerated.

A multi-cohort examine carried out by the College of Florida discovered that each GLP-1RAs and SGLT2 inhibitors (SGLT2is) had been related to a considerably decrease threat of Alzheimer’s illness and associated dementias (ADRD) in comparison with different diabetes medicine.

Utilizing information from over 90,000 sufferers, researchers reported that GLP-1RA customers had a 33% decrease threat and SGLT2i customers had a 43% decrease threat of growing ADRD in comparison with different glucose-lowering medicine. Whereas SGLT2 inhibitors confirmed a barely better relative discount, the distinction between the 2 courses was not statistically vital, suggesting each might provide comparable protecting results.

A second examine led by researchers on the College of Galway additionally helps the concept GLP-1 receptor agonists might assist cut back the danger of dementia. In a systematic evaluate and meta-analysis of 26 randomized scientific trials involving greater than 164,000 members, the researchers discovered a statistically vital affiliation between GLP-1 receptor agonists and decreased dementia threat.

Not like the Florida examine, the Galway evaluation didn’t discover comparable advantages for SGLT2 inhibitors or pioglitazone. These findings counsel that GLP-1 receptor agonists might have a extra distinct function in defending cognitive perform in comparison with different cardioprotective diabetes drugs.

GLP-1 receptor agonists like semaglutide had been initially developed to spice up insulin secretion, decrease blood sugar, and help weight reduction in individuals with sort 2 diabetes.

Researchers have since found that GLP-1 receptors are current not solely within the pancreas and gastrointestinal tract, but additionally within the mind, coronary heart, and immune system. In animal research, GLP-1RAs have been proven to scale back mind irritation, improve synaptic plasticity, and reduce the buildup of amyloid-β and tau proteins, that are key options of Alzheimer’s illness.

In an editorial revealed in JAMA Neurology, Dr. Diana Thiara of the College of California, San Francisco, describes these mind results as “extremely promising,” notably with newer brokers like semaglutide, which have stronger and longer-lasting receptor exercise.

“We’re solely on the precipice,” she writes, referring to ongoing trials of twin and triple hormone agonists which will provide even better neuroprotective potential within the years forward.

Main Part III scientific trials, together with EVOKE and EVOKE Plus, are at present underway to guage the consequences of semaglutide in people with early-stage Alzheimer’s illness. If these findings are confirmed, they might reshape how clinicians strategy each diabetes and dementia, notably in growing older populations the place the 2 situations typically coexist.

GLP-1 receptor agonists usually are not with out dangers. Widespread uncomfortable side effects embrace nausea, vomiting, and lack of lean muscle mass, which can be particularly regarding for older adults who’re already susceptible to sarcopenia. Extra hardly ever, sufferers might expertise pancreatitis, and preclinical research have raised issues a few attainable threat of thyroid most cancers, though this has not but been noticed in people.

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