GLP-1 Receptor Agonists May Improve Outcomes in Idiopathic Intracranial Hypertension
MONDAY, July 21, 2025 -- For patients with idiopathic intracranial hypertension (IIH), glucagon-like peptide 1 receptor agonist (GLP-1 RA) treatment is associated with improved clinical outcomes compared with conventional therapies, according to a study published online July 14 in JAMA Neurology.
Georgios S. Sioutas, M.D., from the Virginia Commonwealth University Health System in Richmond, and colleagues conducted a retrospective cohort study using data from the TriNetX U.S. Collaborative Network between 2005 and 2024. Electronic health records from 67 health care organizations were referenced to examine initiation of GLP1-RA therapy within six months of IIH diagnosis. The control group included patients managed with conventional treatments, such as acetazolamide, topiramate, and dietary counseling.
A total of 44,373 patients with IIH were identified; the cohort included 555 GLP-1 RA users and 555 nonusers, after propensity score matching. The researchers found that use of GLP-1 RAs was associated with lower medication use, reduced headaches, visual disturbances or blindness, and papilledema (risk ratios, 0.53, 0.45, 0.60, and 0.19, respectively). The GLP-1 RA group also had a lower risk of procedures and mortality (risk ratios, 0.44 and 0.36, respectively), but no difference was seen between the groups in mean body mass index (BMI) at follow-up. Similar associations were seen in sensitivity analysis stratified by BMI (≥40 versus <40 kg/m2). Greater weight loss was seen in association with bariatric surgery, but better outcomes were seen in association with GLP-1 RA therapy.
"This retrospective multicenter study suggests GLP-1 RAs may benefit IIH management," the authors write. "However, prospective studies are warranted to validate these findings."
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