Effect of glucagon like peptide-1 receptor agonist exenatide, used as an intracranial pressure lowering agent, on cognition in Idiopathic Intracranial Hypertension

Grech, Olivia; Mitchell, James L.; Lyons, Hannah S.; Yiangou, Andreas; Thaller, Mark; Tsermoulas, Georgios; Brock, Kristian; Mollan, Susan P.; Sinclair, Alexandra J.

doi:10.1038/s41433-023-02908-y

Cited by 4 publications

(1 citation statement)

References 37 publications

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“…Exenatide has also promoted variable cognitive benefit. Positive effects were seen in patients with raised intracranial pressure [57]. Administered to patients with Parkinson's disease, cognition as reflected by the MDS-UPDRS scale, that only weakly reflects cognition, was increased in those receiving exenatide by 2.7 points and declined by 2.2 points in the control patients (p = 0.037) [58].…”

Section: Exenatide and Cognition Or Dementiamentioning

confidence: 92%

All GLP-1 Agonists Should, Theoretically, Cure Alzheimer’s Dementia but Dulaglutide Might Be More Effective Than the Others

Fessel

2024

JCM

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Addressing the dysfunctions of all brain cell types in Alzheimer’s disease (AD) should cure the dementia, an objective that might be achieved by GLP-1 agonist drugs, because receptors for GLP-1 are present in all of the main brain cell types, i.e., neurons, oligodendroglia, astroglia, microglia, endothelial cells and pericytes. This article describes the benefits provided to all of those brain cell types by GLP-1 agonist drugs. The article uses studies in humans, not rodents, to describe the effect of GLP-1 agonists upon cognition, because rodents’ brains differ from those of humans in so many ways that results from rodent studies may not be totally transferable to humans. Commercially available GLP-1 agonists have mostly shown either positive effects upon cognition or no effects. One important reason for no effects is a reduced rate of entering brain parenchyma. Dulaglutide has the greatest entry to brain, at 61.8%, among the available GLP-1 agonists, and seems to offer the best likelihood for cure of AD. Although there is only one study of cognition that used dulaglutide, it was randomized, placebo controlled, and very large; it involved 8828 participants and showed significant benefit to cognition. A clinical trial to test the hypothesis that dulaglutide may cure AD should have, as its primary outcome, a 30% greater cure rate of AD by dulaglutide than that achieved by an equipoise arm of, e.g., lithium plus memantine.

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Section: Exenatide and Cognition Or Dementiamentioning

confidence: 92%

All GLP-1 Agonists Should, Theoretically, Cure Alzheimer’s Dementia but Dulaglutide Might Be More Effective Than the Others

Fessel

2024

JCM

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GLP-1 programs the neurovascular landscape

Chen,

Yu,

Horvath-Diano

et al. 2024

Cell Metabolism

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Semaglutide as an Adjunctive Therapy to Standard Management for Idiopathic Intracranial Hypertension: A Real-World Data-Based Retrospective Analysis

Azzam,

Essibayi,

Vaishnav

et al. 2024

Preprint

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Background: Idiopathic intracranial hypertension (IIH) is a neurological disorder characterized by elevated intracranial pressure, predominantly affecting young women with obesity. This study evaluates the effectiveness of semaglutide as an adjunctive therapy to standard IIH management using real-world data. Methods: We conducted a retrospective cohort analysis comparing IIH patients receiving semaglutide plus standard therapy versus standard therapy alone. After propensity score matching, we analyzed 635 patients in each cohort. Primary outcomes included papilledema, headache manifestations, visual disturbances, and refractory disease status at 3-months, 6-months, 12-months, and 24-months. Secondary outcomes included BMI changes. Results: Semaglutide demonstrated significant improvements across all outcomes. At three months, the treatment group showed reduced risks of visual disturbances (RR 0.28, 95% CI 0.179-0.440, p=0.0001), papilledema (RR 0.366, 95% CI 0.260-0.515, p=0.0001), and headache (RR 0.578, 95% CI 0.502-0.665, p=0.0001). These benefits persisted through 24 months. Refractory disease risk was reduced by 40% at three months (RR 0.6, 95% CI 0.520-0.692, p=0.0001). The semaglutide group showed progressive BMI reduction, with a baseline-adjusted difference of -1.38 kg/m^2 (95% CI [-1.671, -1.089], p<0.0001) at 24 months. Conclusions: Semaglutide as an adjunctive therapy demonstrates significant and sustained improvements in IIH-related outcomes, including visual disturbances, papilledema, and headache symptoms. These findings suggest semaglutide may be a valuable addition to standard IIH management protocols, particularly for patients with refractory disease.

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Effect of glucagon like peptide-1 receptor agonist exenatide, used as an intracranial pressure lowering agent, on cognition in Idiopathic Intracranial Hypertension

Cited by 4 publications

References 37 publications

All GLP-1 Agonists Should, Theoretically, Cure Alzheimer’s Dementia but Dulaglutide Might Be More Effective Than the Others

All GLP-1 Agonists Should, Theoretically, Cure Alzheimer’s Dementia but Dulaglutide Might Be More Effective Than the Others

GLP-1 programs the neurovascular landscape

Semaglutide as an Adjunctive Therapy to Standard Management for Idiopathic Intracranial Hypertension: A Real-World Data-Based Retrospective Analysis

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