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A phase IIb multicentre trial in the UK is further evaluating the effects of liraglutide in mild to moderate AD at 12 months (ELAD, NCT01843075)66: a preliminary analysis in 204 patients showed better cognitive function measured on the Alzheimers Disease Assessment Scale-Executive Domain scale,30 and an update presented at the Alzheimers Association International Conference in 2024 revealed that this medication significantly reduced cognitive decline by 18% compared with placebo, even though this was a secondary outcome which should therefore be interpreted cautiously.67 A large phase III trial (evoke/evoke+) assessing the efficacy, safety and tolerability of oral semaglutide over 3 years, along with informative plasma and CSF biomarkers, in early-stage symptomatic AD is ongoing and expected to be completed in September 2025.68 While these results are pending, the paucity of evidence from randomised data in small samples of patients should be interpreted cautiously
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