Despite earlier hopes that GLP-1 receptor agonists might protect brain function, the EVOKE phase 3 trial found no significant benefit compared to participants who did not receive the medication. A separate group, EVOKE+, which included people with both amyloid buildup and blood vessel damage, showed similar results.
Dr Susan Kohlhaas, Executive Director of Research and Partnerships at Alzheimer’s Research UK, described the findings as disappointing but emphasised that Alzheimer’s involves multiple biological processes. “No single approach is likely to be enough. The field now needs to focus on understanding those processes in much greater detail and developing treatments that can be used together to tackle the disease from multiple angles,” she said.
The trial enrolled participants aged 55 to 85 and targeted those showing amyloid protein accumulation in the brain. Earlier observational studies had suggested that GLP-1 medications might reduce dementia risk, raising hopes for a protective effect. However, the EVOKE results did not support this theory.
Looking ahead, experts see value in the real-world data generated from the increasing use of GLP-1 medicines for weight loss. Dr Kohlhaas noted that such information can inform future research and strengthen the evidence base for Alzheimer’s therapies.
Developing effective treatments will require a multi-pronged approach, combining therapies that remove harmful proteins, protect brain cells, and repair existing damage. “People with Alzheimer’s urgently need better options, and this setback reinforces the need to invest in the science that can drive real progress towards a cure,” Dr Kohlhaas added.
