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Patients who took certain drugs to combat type 2 diabetes proved less likely to develop dementia, according to research that suggests brain disorders could be tackled with therapies devised for other uses.
The study of more than 200,000 people found that rates of Alzheimer’s disease for those who took inhibitors for sodium-glucose cotransporter-2 (SGLT-2), to lower their blood sugar, were more than a third lower than for those on another anti-diabetes medication.
While the observational survey conducted in South Korea does not demonstrate a causal link between SGLT-2 inhibitors and prevention of dementia, more extensive trials of some diabetes drugs such as Novo Nordisk’s Ozempic for similar uses are already under way.
The Danish pharmaceutical company is also looking at the potential for its blockbuster weight-loss drugs, such as Wegovy, to slow cognitive decline among Alzheimer’s sufferers. This reflects an increasing global focus on dementia as life expectancies have risen.
“Dementia is incurable with a grave prognosis — thus, a preventive strategy is critical,” said Eun Ha Kang, co-author of the latest study and a researcher at Seoul National University.
“Therefore, if a common, glucose-lowering agent can reduce the risk of dementia, then the impact would be tremendous from a public health point of view.”
The paper, published in the BMJ on Wednesday, analysed information from the Korea National Health Insurance Service database. It compared 110,885 pairs of adult type 2 diabetes sufferers who started taking either SGLT-2 inhibitors or another class of drug known as dipeptidyl peptidase-4 (DPP-4) inhibitors between 2013 and 2021.
The researchers then looked at new diagnoses of dementia in 1,172 patients during a 670-day follow-up period. They found a 35 per cent reduced dementia risk associated with SGLT-2 drugs compared with DPP-4 inhibitors, including a 39 per cent reduction for Alzheimer’s and 52 per cent for vascular dementia.
Kang acknowledged that observational studies examining dementia were “susceptible to many biases”, such as potential delays in diagnosis of the condition. But she said the study set a “good cornerstone” on which clinical trials could build.
A separate analysis published last month similarly suggested SGLT-2 inhibitors could cut the risk of developing dementia, which is estimated to affect more than 50mn people worldwide.
How a new class of so-called GLP-1 diabetes and weight-loss drugs can be used to treat Alzheimer’s, the most common form of dementia, has also generated excitement.
Novo Nordisk is testing Ozempic on 1,840 patients with early-stage Alzheimer’s. This is part of a series of trials studying the medicine’s effect on other ailments such as alcohol use disorder and Parkinson’s disease. The first results are expected next year.
A study on 204 UK patients looking at the effects on Alzheimer’s of Liraglutide, Novo Nordisk’s predecessor to Ozempic, found that it slowed cognitive decline over the course of a year, compared with the placebo group.
A commentary written by Taiwan-based researchers published in the BMJ alongside the latest study said: “As no cure currently exists for dementia and few effective treatment options are available, strategies that can potentially prevent onset are critically important.”
The rejection last week by the UK’s National Institute for Health and Care Excellence of the Alzheimer’s drug lecanemab on cost-benefit grounds shows the urgent need for new treatments, said Jacqui Hanley, head of research at the charity Alzheimer’s Research UK. Redeploying existing medicines would offer significant advantages, she said.
“Since these drugs have already been shown to be safe for use in people, this could potentially speed up the process of testing them in clinical trials against dementia, as well as making it significantly cheaper,” she said.
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