That is why fat removal injections could also help against Alzheimer’s disease

Gamechanger: This term is often used by experts when it comes to the new weight loss injections such as Ozempic and Wegovy. Because there has never been anything like it to combat the widespread diseases of overweight and obesity. With the medications developed to combat diabetes, weight loss of 20 percent or more is possible. And perhaps there is even more behind the active ingredients that mimic the intestinal hormone GLP-1.

There is some evidence that active ingredients such as semaglutide and the like, found in weight loss injections, can reduce inflammation virtually anywhere in the body – in the liver, kidneys, heart and even in the brain.

This effect makes the drugs so promising for treating neurodegenerative diseases, including Alzheimer’s disease, the most common form of dementia. Characteristic of this are toxic protein deposits – the beta-amyloid plaques and tau fibrils – that are deposited in and between nerve cells. Inflammatory processes caused by the brain’s immune system are also likely to have a harmful influence.

A number of previous studies suggest that GLP-1 receptor agonists may be suitable for the treatment of dementia. This includes a subsequent data analysis of three studies by the pharmaceutical company Novo Nordisk involving diabetes patients. 47 of the patients developed dementia, 32 of them were part of the placebo group, 15 received liraglutide or semaglutide. This represents a 53 percent lower risk for patients treated with the active ingredient.

In a study of 204 Alzheimer’s patients, a team led by neurologist Paul Edison of Imperial College London also tested whether liraglutide could slow the disease. Three years ago he presented the results at the international Alzheimer’s conference in Denver. Accordingly, brain volume shrank less in people given the active ingredient than in the placebo group, and cognitive losses were also less pronounced.

“That sounds promising,” says Ansgar Felbecker, chief physician of the neurology clinic at St.Gallen Cantonal Hospital. But the studies so far have always been very small or conducted for a different purpose. “These were diabetes studies, the dementia results were only a companion result, which severely limits their significance,” Felbecker says. Therefore, larger studies are necessary.

Novo Nordisk is currently implementing one of these projects. It is taking place in parallel in several hospitals in about 40 countries, including about 2,000 patients in the early stages of Alzheimer’s disease. You will be given a semaglutide pill or a placebo every day. The study is expected to be completed in 2026.

Until then, the pharmaceutical company is cautious: especially given the desperate situation of those affected, it is very important not to raise false hopes, because there is still no proven scientific data on a possible effect on the development of Alzheimer’s disease in people. , says Novo Nordisk upon request.

The study is also underway at St.Gallen Cantonal Hospital with a handful of patients. Neurologist Felbecker also tempers expectations: he does not assume that the GLP-1 receptor agonist can directly intervene in the disease mechanism of Alzheimer’s. “Realistically, you should expect that the symptoms will be suppressed, but the disease will continue to progress.”

Hans Pihan, head of neurology and head of the Memory Clinic at Biel Hospital, where the Novo Nordisk study is also taking place, sees it the same way: “In my opinion, reversing the disease will be impossible with therapy, and stopping it will also be impossible. being hard . But braking is certainly possible.” This in itself would be very welcome, as it would allow patients to live a self-determined life for longer, especially those who are mildly affected. This would result in a higher quality of life – for the patients themselves and for their loved ones.

The fact that diabetes medications are becoming the focus of dementia research is nothing new. This is not surprising, because sugar plays a central role in both diseases: if diabetes is not treated, too much of it is constantly circulating in the blood. And high blood sugar levels apparently correlate with more deposits of the toxic Alzheimer’s-typical proteins in the brain. “It has been suspected for more than twenty years that glucose metabolism in the brains of Alzheimer’s patients is disturbed,” says neurologist Felbecker.

For example, there has been suspicion for some time that the diabetes drug metformin reduces the risk of dementia. A large study in the journal “Jama Network Open” with more than 40,000 patients recently confirmed this suspicion. The drug class glitazone also appears to protect against dementia. These are medications that improve the effect of the body’s own insulin on muscle and fat cells.

In recent years, however, it has not been drugs that have made headlines for new treatments for Alzheimer’s disease, but rather therapies that target amyloid deposits in the brain. These monoclonal antibodies include lecanemab, which may slow cognitive decline, especially in the early stages of the disease. It could be approved later this year. From neurologist Pihan’s perspective, it will be such antibodies that open the door wide to effective treatment of Alzheimer’s disease and the hope of a life without dementia.