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Gejl M, Gjedde A, Egefjord L, Møller A, Hansen SB, Vang K, Rodell A, Brændgaard H, Gottrup H, Schacht A, Møller N, Brock B, Rungby J. In Alzheimer's Disease, 6-Month Treatment with GLP-1 Analog Prevents Decline of Brain Glucose Metabolism: Randomized, Placebo-Controlled, Double-Blind Clinical Trial. Front Aging Neurosci. 2016;8:108. Epub 2016 May 24 PubMed.
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UCL Institute of Neurology
This is a small, short-term but exciting study investigating the possible effects of Liraglutide on disease progression in Alzheimer’s. The headline findings are that patients on the active drug had a cessation in the decline of glucose metabolism in the brain as measured by [18F]FDG PET. This is of considerable potential relevance given that decline in this measure has previously been strongly linked to cognitive decline.
The authors are correct to be cautious about the clinical results they observed given the small sample size, chance baseline differences in age and disease duration between the groups, and the failure to achieve conventional levels for statistical significance, but it is encouraging that the overall decline in cognitive performance was also slightly smaller in the Liraglutide treatment group than the placebo group. The drug seemed to be well-tolerated although weight loss (mean 4.9Kg) may be an issue for some patients.
The study did, however, fail to find any difference in the primary outcome measure of amyloid deposition in the brain as measured by [11C] PiB PET binding. Whether this relates to the duration of exposure, stage of disease, or simply reflects insufficient efficacy of the drug remains to be seen.
On balance, this study provides further encouragement to those investigating whether this class of drugs may have potentially important beneficial effects in a range of neurodegenerative processes in the brain.
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