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RecruitingPhase 2

COMMETS- Combination MCI Metabolic Syndrome

Combination of Intranasal Insulin With Oral Semaglutide to Improve Cognition and Cerebral Blood Flow: a Feasibility Study

Asset

Semaglutide

Oral · GLP-1 agonist

Listed sites

1

Recruiting sites

1

Enrollment

80

estimated

Study population

Alzheimer's / cognition, Metabolic syndrome

Key I/E criterion

Primary endpoints

Cognitive change - The effect of the combination of SemaglutideNeuroimaging outcome -- The effect of the combination of Semaglutide

Footprint

Where this trial recruits

Site locations as reported to ClinicalTrials.gov. Site count is not enrollment count; per-site enrollment is not available from source.

Identifiers

Registered as

NCT IDNCT06072963
Org study IDPro2023001136

Timeline

Milestones

Study first posted2023-10-10actual
Study start2024-01-30actual
Last update posted2024-03-22actual
Primary completion2027-12-01estimated
Study completion2028-12-01estimated

Assets

Investigational agents

Study populations

Who this study enrolls

Alzheimer's / cognitionMetabolic syndrome

Eligibility

Who can enroll

Minimum age60 Years
Maximum age90 Years
SexAll
Healthy volunteersNot accepted

Inclusion criteria

Diagnosis of MCI (based on a MOCA <27 and a clinical dementia rating scale [CDR] score of 0.5 representing questionable dementia).
Diagnosis of MetS -requiring
a)abdominal obesity (waist circumference >102cm for men and >88cm for women), and
b)glucose intolerance (fasting glucose>110 mg/dL) and at least one of the following-c) dyslipidemia (high triglycerides [>150 mg/dL] and low HDL [<40mg/dL for men and <50 mg/dL for women]), or
d)elevated blood pressure (>130/>85 mmHg).
Fluent in Hebrew
The study requires an active study partner

Exclusion criteria

Diabetes (of any type)
Taking medications that may affect glucose metabolism (including a GLP-1RA).
Diagnosis of dementia and its subtypes, conditions that may directly affect cognition,
short life expectancy or a medical condition that precludes consistent participation in the study,
contraindications to either insulin or Semaglutide.
Medications that may affect glucose metabolism such as corticosteroids.

Endpoints (15)

What's being measured

Protocol endpoints and posted registry outcome measures, grouped into outcome categories. Composite endpoints show their component event types. Standard codes (LOINC, SNOMED CT) are shown where available.

Coverage by outcome category

Other clinical outcomes
13
Patient-reported / QoL
1
Other (unclassified)
1

Patient-reported / QoL

1 endpoint
Secondary/protocol endpoint

Functional outcome - The effect of the combination of Semaglutide with intranasal inulin on change in functional performance as measured by IADL (instrumental activities of daily living) questionnaires.

Time frame:12 months

change from baseline, improvement

Other clinical outcomes

13 endpoints
Primary/protocol endpoint

Cognitive change - The effect of the combination of Semaglutide and intranasal insulin on cognitive functioning.

Time frame:12 months

change from baseline, improvement

Primary/protocol endpoint

Neuroimaging outcome -- The effect of the combination of Semaglutide and intranasal insulin on brain glucose intake.

Time frame:6 months

change from baseline, improvement

Secondary/protocol endpoint

Change in specific cognitive domains - The effect of the combination of Semaglutide and intranasal insulin on executive functions and episodic memory.

Time frame:12 months

change from baseline, improvement

Secondary/protocol endpoint

Neuroimaging outcomes- The effect of the combination of Semaglutide and intranasal insulin on microstructural alterations indicative of tissue injury.

Time frame:6 months

change from baseline, improvement

Secondary/protocol endpoint/low confidence

Neuroimaging outcomes- The effect of the combination of Semaglutide and intranasal insulin on gray matter and hippocampal volume.

Time frame:6 months

change from baseline, improvement

Secondary/protocol endpoint

Functional outcome - The effect of the combination of Semaglutide and intranasal insulin on functional performance.

Time frame:12 months

change from baseline, improvement

Secondary/protocol endpoint

Functional outcome - The effect of the combination of Semaglutide and intranasal insulin on physical capacity

Time frame:6 months

categorical status, improvement

Secondary/protocol endpoint

Neurobiological outcome - The effect of the combination of Semaglutide and intranasal insulin on ADRD-blood biomarkers- Aβ.

Time frame:6 Months

ratio, improvement

Secondary/protocol endpoint

Neurobiological outcome - The effect of the combination of Semaglutide and intranasal insulin on ADRD-blood biomarkers- P-tau181.

Time frame:6 Months

change from baseline, improvement

Secondary/protocol endpoint/low confidence

Neurobiological outcome - The effect of the combination of Semaglutide and intranasal insulin on ADRD-blood biomarkers-P-tau231.

Time frame:6 Months

change from baseline, improvement

Secondary/protocol endpoint

Neurobiological outcome - The effect of the combination of Semaglutide and intranasal insulin on ADRD-blood biomarkers- T-tau.

Time frame:6 Months

change from baseline, improvement

Secondary/protocol endpoint

Neurobiological outcome - The effect of the combination of Semaglutide and intranasal insulin on ADRD-blood biomarkers- Neurofilament light (NfL).

Time frame:6 Months

change from baseline, improvement

Secondary/protocol endpoint

Neurobiological outcome - The effect of the combination of Semaglutide and intranasal insulin on ADRD-blood biomarkers- glial fibrillary acidic protein (GFAP).

Time frame:6 Months

change from baseline, improvement

Other (unclassified)

1 endpoint
Primary/protocol endpoint/low confidence

Neuroimaging outcome -- The effect of the combination of Semaglutide and intranasal insulin on cerebral blood flow (CBF).

Time frame:6 months

change from baseline, descriptive

Publications (58)

Bibliography

Records linked to this trial through ClinicalTrials.gov references, PubMed NCT search, and curated study seeds. 'Canonical' marks design/result papers; others are registry references or candidates.

Registry references + supporting bibliography

Provenance

Sources

Trial identity, design, statusClinicalTrials.gov API v2
Snapshot dateJuly 1, 2026
Endpoint classificationDelfa endpoint taxonomy v2 (May 13, 2026)
Results tableno registry results posted yet

Trial facts come from public ClinicalTrials.gov records. Endpoint categories are Delfa's classification of those records, not a ClinicalTrials.gov field. All figures reflect the July 1, 2026 snapshot.