At CTAD 2025, all eyes will be on GLP-1 therapies as Novo Nordisk shares new data from its semaglutide Alzheimer’s programme. Following the recent announcement that the EVOKE and EVOKE+ trials did not meet their primary clinical endpoint, attention is now turning to the more granular data to be presented at CTAD—particularly the reported improvements in Alzheimer’s-related biomarkers. These biomarker signals, despite the lack of clinical efficacy, will be important for understanding patient heterogeneity, underlying mechanisms, and how metabolic, vascular, and inflammatory pathways intersect in Alzheimer’s disease.

With metabolic and vascular mechanisms increasingly intersecting in Alzheimer’s research, CTAD provides an ideal backdrop to revisit the role of vascular co-pathology.  Cerebrovascular disease is present in a significant proportion of people with Alzheimer’s and is now recognised as a key co-pathology in the NIA-AA framework. Yet most AD trials include participants with mild–moderate vascular burden without measuring its impact—despite evidence that markers such as white-matter hyperintensities influence cognitive decline, interact with amyloid and tau pathology, and can mask or dilute treatment effects when not accounted for.

IXICO’s scientific roadmap directly addresses this gap. Building on several validated MRI analysis solutions on the IXI platform and years of vascular visual-read experience, we are now working with leading experts on generating the evidence required to bring advanced vascular biomarkers into routine use as endpoints in AD trials. Our partnership with the Global Alzheimer’s Platform Foundation in Bio-Hermes-002 strengthens our ability to validate multimodal vascular biomarkers at scale, including in traditionally underrepresented populations.

As mechanisms like GLP-1s gain prominence, understanding vascular burden is becoming essential for trial design, safety, subgroup analysis and interpretation of outcomes. CTAD marks the perfect moment to highlight why vascular phenotyping is no longer optional—but a critical component of designing, powering, and interpreting the next generation of Alzheimer’s trials.

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