Novo Nordisk Just Released Semaglutide’s Alzheimer’s Results. Here Is What You Need To Know.

Original posted at obesity.news/ on Nov 24, 2025

I knew when I wrote about the Evoke trials this past weekend that we were standing close to a moment that could go either way. A massive breakthrough or another heartbreak in a field that has already had more heartbreak than almost any disease area. This morning, Novo Nordisk released the top line results from the two year Evoke and Evoke Plus trials in early stage Alzheimer’s. And while the news is mixed, it fell far short of what we were hoping for.

Oral semaglutide improved Alzheimer’s related biomarkers. That means the biology was moving in the right direction. Something inside the brain was shifting. Something measurable. Something real. But that biological change did not translate into a slowing of clinical progression. People did not decline slower. They did not maintain those everyday functions that the CDR Sum of Boxes is built to measure. The clinical reality did not match the biological hope.

Because of this, Novo is discontinuing the extension phase of the trials. The long term follow up will not continue. Full data will be presented at CTAD on December 3, and the field will go over every inch of it. Every signal. Every secondary outcome. Every subgroup. Every pathway that might still hold a clue for the future.

This is the part that hurts. Not because we believed semaglutide was guaranteed to work, but because so many of us carry this disease inside our families. We know the slow ache of watching someone fade. We know the way the simplest memories become slippery. We know the fear that comes with seeing a person you love lose pieces of themselves without losing their life. We wanted a different outcome. We hoped to be writing a different story this week.

But even in this disappointment, there is something important happening here. The biomarker improvement matters. It does confirm for researchers that the GLP-1 pathway touches the brain in a meaningful way. It tells us that metabolic health and cognitive health are not these entirely separate universes. It tells us that something about this class of medicines reaches into inflammation, vascular tone, and neural signaling in ways we still do not fully understand. The gap between biomarker change and clinical change is not necessarily failure. It is information. And information is what moves fields forward.

Alzheimer’s research has lived through decades where nothing moved. Nothing budged. Nothing gave even a hint of possibility. Today, we got information we did not have yesterday. We got clarity. We got direction. And we got a reminder that even the drugs we already use for weight and metabolic disease have effects that reach further into the body than we imagined.

For everyone who wrote to me after our last article sharing stories about your parents, your grandparents, your spouses, your grief, I want you to know this. This work is not over. This pathway is not done being explored. And this moment, even though it hurts, is not the end of the story. It is one more step in a field that has been climbing a mountain for decades with nothing but hope in its hands.

Full data is coming December 3. We will go through it together, line by line, and no matter what the science shows, the people inside this disease will remain at the center of the conversation. Because for so many of us, this is not just news. It is personal.

Stay tuned to On The Pen for full coverage when CTAD begins.

This article is reader-supported on Substack.

To receive new posts and support my work,

consider becoming a free or paid subscriber.

Subscribe