Decera Clinical Education Neuroscience Podcast · Decera Clinical Education

Cognitive Conversations: Key Findings on Alzheimer’s Disease Presented at CTAD

·38 min·2 clips

EVOKE and EVOKE Plus showed no impact on Alzheimer's disease despite two years of oral semaglutide.

1. Decera Clinical Education Neuroscience Podcast episode 'Cognitive Conversations: Key Findings on Alzheimer’s Disease Presented at CTAD' centers on the 2026 Clinical Trials on Alzheimer's Disease meeting in San Diego. 2. Nicola Hansen introduces Dr. Anton Thorstensen, Director of the Alzheimer's Disease Care Research and Education Program at the University of Rochester, and Dr. Vijay Ramanan, Director of the Alzheimer's Disease Treatment Clinic at Mayo Clinic in Rochester, Minnesota. 3. The episode asks what CTAD 2026 means for clinical practice, especially after several late-phase Alzheimer's disease presentations. 4. Anton Thorstensen says the EVOKE and EVOKE Plus studies of oral semaglutide were large, randomized, and placebo-controlled for two years. 5. He describes the EVOKE data as disappointing because there was no impact on cognition, function, or the course of Alzheimer's disease. 6. Vijay Ramanan frames the GLP-1 question as a repurposing problem, with observational and retrospective studies suggesting possible dementia signals. 7. The speakers note that the semaglutide group showed biomarker changes, weight loss, improved glucose control, and a roughly 30% mean reduction in high-sensitivity CRP. 8. Anton and Vijay both stress that the biomarker changes did not translate into a clinical benefit in the trial. 9. They discuss whether timing, duration, CNS penetration, or APOE4 homozygous biology could still matter for future GLP-1 research. 10. The conversation turns to subcutaneous lecanemab, which is already approved for maintenance after 18 months of intravenous therapy. 11. Vijay explains that his clinic has often offered maintenance IV lecanemab and that many patients choose to continue once-monthly infusions. 12. Anton raises the FDA fast-track rolling submission for subcutaneous initiation of lecanemab and says a decision could come in the first half of 2026. 13. Both speakers weigh convenience against the need for close ARIA monitoring, especially during the first three to six months of treatment. 14. The biomarker discussion highlights blood-based testing as a major area of rapid change in Alzheimer's disease. 15. Vijay explains that amyloid PET remains the in vivo gold standard, while CSF biomarkers and plasma assays each have strengths and limitations. 16. He says the Mayo Clinic presentation led by Alicia Algeciras-Schmitz showed that the FDA-approved plasma p-tau217 to A-beta-42 ratio can differ from isolated p-tau217. 17. The speakers emphasize that analyte stability, cohort differences, and cut points can alter whether a patient is classified as amyloid positive or negative. 18. Anton and Vijay describe trontinemab as a repurposed gantenerumab construct using brain shuttle technology to increase CNS penetration and potentially lower systemic dosing. 19. They also review tau-targeting setbacks, including Johnson & Johnson's mid-domain antibody failure, and they mention vaccine epidemiology around shingles and BCG as another area needing randomized trials. 20. The tone is practical and collegial, with two clinical experts comparing trial readouts, implementation questions, and near-term regulatory changes for listeners working in Alzheimer's care.

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CTAD updates, grounded in the practical realities of Alzheimer's care.

This update turns the 2026 Clinical Trials in Alzheimer`s Disease meeting into a practical look at what may change in clinic. It is strongest when it balances the subcutaneous formulation, infusion-center routines, and the tradeoff between flexibility and monitoring, giving the…

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