Semaglutide May Lower Risk of Alzheimer Disease in Patients With Type 2 Diabetes

Patients with type 2 diabetes and obesity prescribed semaglutide had a 40% to 70% lower risk of a first-time Alzheimer disease (AD) diagnosis compared with patients taking other antidiabetic medications, according to a study published in Alzheimer’s & Dementia.

“This new study provides real-world evidence for its impact on AD, even though preclinical research has suggested that semaglutide may protect against neurodegeneration and neuroinflammation,” said corresponding author Rong Xu, PhD, of the Center for Artificial Intelligence in Drug Discovery at Case Western Reserve University School of Medicine, Cleveland, Ohio.

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Researchers used data for more than 1 million patients in the United States with type 2 diabetes and no prior diagnosis of AD to investigate the risk of an AD diagnosis with semaglutide, a glucagon-like peptide (GLP-1) receptor agonist, compared with other antidiabetic medications. The study consisted of 7 emulation target trials that separately compared semaglutide with insulin, metformin, dipeptidyl-peptidase-4 inhibitors, sodium-glucose cotransporter-2 inhibitors, sulfonylureas, thiazolidinediones, and other GLP-1 receptor agonists (albiglutide, dulaglutide, exenatide, liraglutide, and lixisenatide).

Patients prescribed semaglutide had a significantly reduced risk for first-time AD diagnosis during a 3-year follow-up period, according to the study. Hazard ratios for a diagnosis of AD with semaglutide ranged from 0.33 compared with insulin to 0.59 compared with other GLP-1 receptor agonists.

Reductions were similar across obesity status, gender, and age groups, researchers reported.

“Our findings support further clinical evaluation of semaglutide’s role in mitigating AD initiation and development in patients with type 2 diabetes mellitus,” researchers wrote. “Future research should explore its effects in mild cognitive impairment, other dementias, and neurodegenerative diseases, as well as investigate other GLP-1RAs like tirzepitide and combination therapies with other antidiabetic medications.”

References

Wang W, Wang Q, Qi X, et al. Associations of semaglutide with first-time diagnosis of Alzheimer's disease in patients with type 2 diabetes: target trial emulation using nationwide real-world data in the US. Alzheimers Dement. Published online October 24, 2024. doi: 10.1002/alz.14313

Popular diabetes and weight-loss drug may reduce risk of Alzheimer’s disease. News release. Case Western Reserve University; October 24, 2024. Accessed November 1, 2024.