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Semagludtide

Phase 3

Early Alzheimer's Disease | Small molecule | Neurology |Novo Nordisk A/S|Last Updated: Apr 9, 2026

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials1
Total Enrollment1,840
FDA Designations
No designations recorded
Clinical Trials (1)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT04777396A Research Study Investigating Semaglutide in People With Early Alzheimer's Disease (EVOKE)PHASE3 COMPLETED 1,840May 18, 2021Jan 30, 2026Apr 9, 2026444 United States, Argentina +35
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Study Endpoints
Primary Endpoints
Change in the Clinical Dementia Rating - Sum of Boxes (CDR-SB) score
From baseline (week 0) to week 104

Score on scale (0 to 18) Measures the impact of cognitive decline on daily function using the following six domains commonly affected in Alzheimer's disease: * Cognitive domains: memory, orientation, and judgement and problem solving * Function domains: community affairs, home and hobbies, and personal care Based on clinical information obtained from the subject and informant, an individual box score ranging from 0 to 3 is determined that represents "none" to "severe" impairment for each of the six domains. The CDR-Sum of Boxes (CDR-SB) score will be derived by adding the individual scores of the six domains at a given time point. The total CDR-SB score ranges from 0 to 18 with higher scores representing greater impairment.

Secondary Endpoints
Main Phase: Change in the 24-item Alzheimer's Disease Cooperative Study Activities of Daily Living Scale for Mild Cognitive Impairment (ADCS-ADL-MCI) score
From baseline (week 0) to week 104
Extension Phase:Change in the ADCS-ADL-MCI (Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory-Mild Cognitive Impairment ) score
From baseline (week 0) to week 156
Main Phase: Time to progression to Clinical Dementia Rating (CDR) global score greater than or equal to (≥) 1.0 among patients with CDR global score equal to (=) 0.5 at baseline
From baseline (week 0) up to week 156
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Study Design & Arms
AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Oral SemaglutideEXPERIMENTALParticipants are given oral semaglutide once daily
Placebo (semagludtide)PLACEBO_COMPARATORParticipants are given oral placebo once daily
Interventions
NameTypeDescription
SemagludtideDRUGOral semaglutide once-daily, dose gradually increased to 14 mg. The study will last for up to 173 weeks
Placebo (semaglutide)DRUGOral placebo (semaglutide) once-daily, The study will last for up to 173 weeks
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Eligibility Criteria
Age Range55 Years — 85 Years
SexALL
Healthy VolunteersNo
Study Sites444

Inclusion Criteria: * Male or female, aged 55-85 years (both inclusive) at the time of signing informed consent. * MCI (mild cognitive impairment) or mild dementia of the Alzheimer's type according to the NIA-AA (National Institute of Aging-Alzheimer's Association) 2018 criteria. * CDR (Clinical De...

Countries:United StatesArgentinaAustraliaAustriaBelgiumBrazilBulgariaCanadaCzechiaDenmarkFinlandFranceGermanyGreeceHungaryIrelandIsraelItalyJapanMexicoNetherlandsNorwayPolandPortugalRomaniaRussiaSerbiaSlovakiaSloveniaSouth AfricaSouth KoreaSpainSwedenSwitzerlandTurkey (Türkiye)UkraineUnited Kingdom
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Recent Changes (Last 90 Days)
MEDIUMMay 26, 2026NCT04777396TRIAL_REMOVED: changed
LOWMay 24, 2026NCT04777396studyFirstPostDate: changed