Novo Nordisk reported that two large phase III trials testing oral semaglutide failed to slow progression of early Alzheimer’s disease. The Evoke and Evoke+ studies enrolled thousands of patients with biomarker‑confirmed amyloid pathology and found no clinical benefit on standard cognitive outcome measures. The negative readouts undercut optimism that GLP‑1 receptor agonists could translate metabolic benefits into disease‑modifying neuroprotection. Novo flagged biomarker changes in trial cohorts but acknowledged they did not translate into improved clinical outcomes. Investors and R&D teams will reassess GLP‑1 neuro programs and prioritize mechanistic follow‑ups to reconcile biomarker signals with clinical failure.