Ozempic found not to slow down the progression of Alzheimer's - What does this mean for the future?

Novo Nordisk announced on November 24, 2025 that the Phase 3 EVOKE and EVOKE+ studies showed no statistically significant effect of semaglutide on slowing Alzheimer's disease.
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Abstract:
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The two studies lasted two years, included a total of 3,808 participants aged 55-85 years with early Alzheimer's disease or mild cognitive impairment and confirmed amyloid pathology.

Semaglutide improved some Alzheimer's biomarkers, but this did not lead to a reduction in disease progression as measured by the standard Clinical Dementia Rating - Sum of Boxes (CDR-SB).
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As the studies did not show any clinical benefit, the planned one-year extension phase will be discontinued.

The results will be presented at the CTAD conference on December 3, 2025 and fully reported at the AD/PD conference in spring 2026.

In the background, Novo Nordisk also describes the great medical need for new treatments that can slow the progression of Alzheimer's and how CDR-SB is used as a standard measure to monitor cognitive decline in clinical trials.

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‍Whywas there no impact - despite hope and previous data?

Semaglutide, approved for type 2 diabetes and weight loss, has shown promising signs in previous preclinical studies and observational data: reduced inflammation, better metabolic parameters and biomarker changes - raising the idea that it could also affect neurodegeneration.

But EVOKE shows that improving biomarkers is not enough - real clinical impact is needed. This provides clear evidence that biomarker effects do not automatically mean that cognitive decline is slowed.

The case of EVOKE also illustrates the difficulties of treating Alzheimer's: the disease is multifactorial and complex. Targeting only the metabolism/GLP-1 pathway has proven insufficient to influence the clinical course of the disease in the mild dementia patient group.

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What does it mean for patients, prevention and future treatment?‍

- For patients and clinics

• Semaglutide - although well tolerated - should not be considered as a treatment for Alzheimer's disease.
• Those hoping that "weight and diabetes drugs save the brain" must now realize that the evidence to slow down the progression of the disease is not there.
• It is important for patients and families to understand that biomarker changes are not necessarily synonymous with real protection against disease deterioration.‍

- For prevention and research orientation

• The EVOKE outcome reinforces the fact that we need multimodal strategies - not a "silver bullet".
• Prevention (lifestyle, brain health, risk factor management) and early detection become even more central.
• Combination therapies (e.g. anti-amyloid + metabolic/anti-inflammatory + lifestyle interventions) may gain more traction.
• The research field is learning -> biomarkers are interesting, but primary clinical outcome measures are required.

- What does this mean for the work ahead?

• The EVOKE message makes it clear that preventive and supportive interventions (e.g. digital screening, lifestyle optimization, cognitive health) are becoming even more important - medicines alone cannot bear the responsibility.
• Effective early detection tools that can handle large patient volumes, monitoring and personalized care take on even greater value in a scenario where drug options are limited.
• It sharpens the need to develop holistic models for early diagnosis + long-term care planning + lifestyle intervention..
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Conclusion

Evoke and Evoke+ mark a clear and important step in Alzheimer's research: even well-motivated and large-scale trials can 'fail'. In research, a negative result is also an important result. It provides the world with valuable lessons that shape future research to get closer to understanding and solving the problems they are trying to solve.
The negative outcome therefore does not send us back to square one, but takes us one step forward. For patients, the lesson is that we need a broader arsenal - prevention, care and developing structures around 'life-with-disease'. For research, the lesson is that we need to continue to explore the complexities of dementia - and of the field of cognitive health. Finally, that there is a great need for person-centered, individualized solutions already now.

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