Novo Nordisk's Semaglutide Fails in Alzheimer's Trials, Boosting Biogen's Leqembi Prospects
Key Insights
Novo Nordisk's semaglutide failed to reduce Alzheimer's disease (search) progression in two Phase III trials (EVOKE and EVOKE+), removing competitive pressure on existing amyloid (search)-targeting therapies.
The failure eliminates a potential impediment to uptake for Biogen's Leqembi, which has been hindered by diagnostic and administration bottlenecks but remains the only true disease-modifying option.
Biogen stock rose 2.6% following the news, with analysts noting the softened competitive landscape could accelerate Leqembi sales and benefit the broader beta-amyloid (search) antibody class.
Novo Nordisk's highly anticipated foray into Alzheimer's disease (search) treatment hit a significant roadblock as the company announced that semaglutide failed to reduce disease progression in two Phase III trials, EVOKE and EVOKE+. The failure removes a potential competitive threat to existing amyloid (search)-targeting therapies and provides a boost to Biogen's Leqembi franchise.
The studies were inspired by real-world evidence suggesting that Novo's blockbuster GLP-1 (search) receptor agonist could have an effect on the memory-robbing disease. However, the trials failed to meet their primary endpoints, dealing a blow to hopes that the diabetes and obesity drug class could expand into neurodegenerative diseases.
Market Impact on Biogen
Biogen stock rose 2.6% to $179.75 per share as markets opened Monday following the announcement. Analysts viewed the semaglutide failure as removing an overhang that had been weighing on the company's Alzheimer's prospects.
"The outcome technically removes an overhang for [Biogen], enabling the competitive landscape to soften and Leqembi (abeta) sales to potentially accelerate," Jefferies analysts wrote in a note to investors.
Stifel analysts agreed that the failure "removes a modest overhang" on Biogen, noting that while expectations for the semaglutide trials were generally low, success could have resulted in "another impediment to uptake for abeta antibodies, which have been hindered by a number of bottleneck issues (diagnostics, IV infusions, MRIs, etc)."
Competitive Landscape Dynamics
Biogen and partner Eisai currently compete in the Alzheimer's market alongside just one competitor, Eli Lilly's Kisunla, also an anti-amyloid (search) antibody. The limited competition has allowed Leqembi to gain traction, particularly following recent regulatory approvals for more convenient formulations.
Jefferies noted that even if the Novo trials had been successful, there could have been potential upside for Biogen. A positive readout for semaglutide "could have improved uptake of Abeta drugs with another player in the Alzheimer's market driving increased awareness."
RBC Capital Markets analysts emphasized that the semaglutide trials had been a "perceived overhang" on Biogen. "Now through the sema data, and solidifying that while not perfect, the beta-amyloid (search) class remains the only true disease-modifying option in Alzheimer's, we believe this should clear the way for appreciation into what we expect will be a more eventful late-'25/2026," the analysts wrote.
Leqembi's Recent Progress
Biogen has made significant strides with Leqembi throughout 2024. The FDA approved Leqembi Iqlik, a subcutaneous formulation of the therapy, in September, followed by an October launch. BMO Capital Markets noted at the time that the subcutaneous version "could expand access" to Leqembi "as more patients push into longer term treatment."
Biogen is also anticipating an FDA decision on a subcutaneous induction formulation of Leqembi, with Jefferies expecting approval to arrive in mid-2026.
Future Trial Readouts
Looking ahead, analysts are focused on upcoming data readouts that could further validate the amyloid (search)-targeting approach. Jefferies is anticipating the readout of Lilly's TRAILBLAZER-ALZ-3 study, which is studying Kisunla in patients with preclinical Alzheimer's disease (search). While the trial is slated to wrap in November 2027, data could arrive as early as the end of this year or the first half of 2026.
"We think positive data could ultimately derisk the broader abeta class," Jefferies analysts wrote. The study could also provide a positive read-through for Leqembi's AHEAD 3-45 trial, which "may have a more robust study design." AHEAD 3-45 is studying Leqembi in people with preclinical Alzheimer's and elevated amyloid (search), and in those with early preclinical Alzheimer's and intermediate amyloid, with data expected in 2028 at the earliest.
Novo's Biomarker Findings
Despite the primary endpoint failures, Novo Nordisk reported improvements in Alzheimer's disease (search)-related biomarkers in both EVOKE and EVOKE+ trials. The company will present topline results from the trials on December 3 at the Clinical Trials on Alzheimer's Disease (CTAD) conference in San Diego.
Jefferies analysts said they were looking forward to the presentation, which may provide additional insights into semaglutide's effects on Alzheimer's pathology despite the clinical failure.