Phase 3 · Semaglutide

NCT05891496 trial results

A Randomised Double-blind Placebo-controlled Clinical Study Investigating the Effects of Semaglutide s.c. Once-weekly Versus Placebo on Central and Peripheral Inflammation in Participants With Alzheimer's Disease

Change in Gene Expression Assessed by Single-cell Ribonucleic Acid Sequencing (scRNAseq) (Cells in Cerebrospinal Fluid [CSF]) (Differentially expressed genes), Baseline (week 0), week 12. Semaglutide: 41.25; Placebo: 21.00.

Participants
23
Status
completed
Completed
2025-09-08
Sponsor
Novo Nordisk A/S

As posted on ClinicalTrials.gov (NCT05891496), updated at source Aug 18, 2026. Read again whenever the registry updates it. Registry figures can differ from a published paper, which may use another analysis.

Primary outcome

What NCT05891496 measured first

Change in Gene Expression Assessed by Single-cell Ribonucleic Acid Sequencing (scRNAseq) (Cells in Cerebrospinal Fluid [CSF])Differentially expressed genes · Baseline (week 0), week 12 · mean
Semaglutiden=4Placebon=7
41.25(29.68)21.00(25.70)
Change in Gene Expression Assessed by scRNAseq (Cells in Blood)Differentially expressed genes · Baseline (week 0), week 12 · mean
Semaglutiden=7Placebon=6
10.00(5.97)16.50(15.86)
Side effects by arm

Side effects in NCT05891496

Percent of participants affected, From baseline (week 0) to end of study (week 69). The most common events the registry lists.

EventSemaglutide Period 1PlaceboSemaglutide Period 2
Any serious event0%0%4.5%
Weight decreased45.5%8.3%27.3%
Decreased appetite36.4%0%22.7%
Nausea36.4%8.3%31.8%
Abdominal pain upper18.2%0%0%
Dyspepsia18.2%0%4.5%
Fatigue18.2%0%4.5%
Nasopharyngitis18.2%0%9.1%
Catarrh9.1%0%0%
Constipation9.1%0%4.5%
Dizziness9.1%0%0%
Eczema0%0%9.1%
Eosinophilia9.1%0%0%
Epistaxis9.1%0%0%
Gastroenteritis viral9.1%0%0%
Gastrooesophageal reflux disease0%0%9.1%
Haemorrhoids9.1%0%0%
Vomiting9.1%8.3%9.1%
Back pain0%8.3%0%
Headache0%8.3%4.5%
Lymphadenitis0%8.3%0%
Pneumonia bacterial0%8.3%0%
Presyncope0%8.3%0%
Secondary outcomes

What else it measured

Number of Treatment Emergent Adverse Events (TEAEs)Events · From baseline (week 0) to week 12 · number
Semaglutiden=11Placebon=12
318
The trial

How NCT05891496 was run

The study is being conducted to understand how the medicine, semaglutide, affects the immune system and other biological processes in people with Alzheimer's disease. Semaglutide is a medicine that doctors can prescribe in some countries for the treatment of type 2 diabetes and excess body weight. This study will help us understand whether semaglutide can also be used for the treatment of Alzheimer's disease. The study will last for about 77 weeks. In the first 12 weeks of treatment, participants will either get semaglutide (active medicine) or placebo (inactive dummy medicine). Which treatment participants get is decided by chance. In the following 52 weeks of treatment, all participants taking part in the study will get semaglutide. Participants must have a study partner, who is willing to take part in the study. Participants will get study medicine in a pen injector. The study partner will need to inject the study medicine into the skin of participant's stomach, thigh or upper arm once every week.

  • Study intervention period 1: Participants will receive either semaglutide or placebo matched to semaglutide once-weekly subcutaneous (s.c.) injections for 12 weeks as an add on therapy to standard of care. Participants initially received 0.25 milligram (mg) once weekly and the dose was then escalated once in 4 weeks until the maintenance dose (1.0 mg) was reached: 0.25 mg (week 1 to week 4), 0.5 mg (week 5 to week 8), 1.0 mg (week 9 to week 12).
  • Study intervention period 2: All participants will receive 1.0 mg semaglutide s.c. injections once weekly for 52 weeks during study intervention period 2 as an add-on therapy to standard of care. Participants randomised to semaglutide s.c. 1.0 mg during study intervention period 1 remained on 1.0 mg target maintenance dose for 52 weeks from weeks 12-64. Participants initially randomised to placebo during study intervention period 1 will receive semaglutide s.c. in dose escalation fashion for 8 weeks (0.25 mg from weeks...
Who could join the trial

Inclusion Criteria: * Male or female, aged 55-75 years (both inclusive) at the time of signing the informed consent * Mild cognitive impairment (MCI) or mild dementia of the Alzheimer's type according to the National Institute on Aging- Alzheimer's Association (NIA-AA) 2018 criteria * Clinical dementia rating (CDR) global score of 0.5 or 1 at screening (visit 1) * Amyloid positivity established with either historical amyloid positron emission tomography (PET) or historical cerebrospinal fluid (CSF) Aβ1-42 or historical CSF Aβ1-42/Aβ1-40 (historical data within the last 5 years) or blood sample for amyloid biomarker (Aβ42/Aβ40 ratio and p-tau217/np-tau217 ratio) at screening (visit 1) * Treated with acetylcholinesterase inhibitors (approved for the treatment of Alzheimer's disease) and on stable dose for greater than 90 days before screening (visit 1) Exclusion Criteria: * Brain magnetic resonance imaging (MRI) scan suggestive of clinically significant structural central nervous system (CNS) disease confirmed by local read (example cerebral large-vessel disease \[large vessel (cortical) infarcts greater than 10 millimeter (mm) in diameter\], prior macro-haemorrhage \[greater than 1centimeter cube (cm\^3)\], cerebral vascular malformations, cortical hemosiderosis, intracranial aneurism(s), intracranial tumours, changes suggestive of normal pressure hydrocephalus) * Brain MRI scan suggestive of significant small vessel pathology confirmed by local read and defined as greater than 1 lacunar infarct and/or white matter hyperintensity (WMH) Fazekas13 scale greater than 2, (white matter \[WM\] greater than 20 mm) in the deep white matter and periventricular regions * History or evidence of autoimmune diseases such as inflammatory bowel disease, rheumatoid arthritis, lupus, glomerulonephritis, psoriasis (but not limited to): Any other medical condition that would require use of systemic corticosteroids or immunosuppressants or immunostimulants in the 12 months prior to screening (visit 1) * Received a vaccine product (including booster) 4 weeks prior to screening (visit 1) or expected to receive a vaccine product (including booster) before visit 5 * Use of any systemic immunomodulating drugs (small molecules and/or biologics) in the last 12 months prior to screening (visit 1) or anticipated use of such drugs during study intervention period 1 (i.e., during the first 12 weeks of treatment until visit 5), such as corticosteroids for systemic use, immunostimulants and immunosuppressants

Trial averages do not predict what one person will experience. Results are shown as the registry posts them, without interpretation.

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