Analysis of Glucagon-Like Peptide-1 Receptor Agonist (GLP-1-RA) Use in Patients with Idiopathic Intracranial Hypertension (IIH)

Background: Glucagon-like peptide-1 receptor agonists (GLP-1-RAs), such as exenatide, semaglutide, and liraglutide, have been shown to be effective weight loss medications and their use is becoming increasingly more common. GLP-1-RAs were first approved by the U.S. Food and Drug Administration (FDA) in 2005 for the treatment of diabetes, however they have recently become of interest in the treatment of idiopathic intracranial hypertension (IIH). The use of GLP-1-RAs in patients with IIH has been correlated with promising clinical outcomes including higher degrees of weight loss, reduction in headaches, and decreased required dose of acetazolamide. The abrupt cessation of GLP-1-RAs has also been proposed to contribute to the consequent development or worsening of IIH. We sought to investigate the use of GLP-1-RAs in patients with IIH and to highlight relevant trends seen in these patients.

Materials and Methods: TriNetX, a multi-institutional database, was queried for all adult patients with a diagnosis of IIH from 2014 to 2023 as well as those with a diagnosis of IIH who underwent ventriculoperitoneal (VP) shunt during that same period. Patients were divided into cohorts based on documented prescription of a GLP-1-RA, including semaglutide, liraglutide, dulaglutide, exenatide, lixisenatide, or tirzepatide.

Results: A total of 3,687 patients with IIH were included in this analysis. There was a significant increase in patients with IIH on GLP-1-RAs year to year (p < 0.001). There was no significant change in patients with IIH undergoing VP shunt (p = 0.704). GLP-1-RA use was negatively associated with age (p = 0.0397), but there was no association seen with other demographic factors such as gender and race.

Conclusion: GLP-1-RAs are becoming progressively more common in popular culture and in clinical practice. Our results demonstrate that over the years patients with IIH have been more frequently prescribed GLP-1-RAs, and that GLP-1-RA use is more often seen in younger patients with IIH. A multi-institutional study with larger patient numbers and prospective design is needed to further investigate the use of GLP-1-RAs in patients with IIH.

Table 1 Clinical and demographic Information

	No GLP-1-RA (n = 3687)	GLP-1-RA (n = 209)
Age, average (SD)	35.7 (19.9)	44.9 (12.9)
Sex (female)	63.9%	82.8%
White	63.3%	64.1%
Black	20.7%	24.4%
Asian	2.25%	4.78%
Other	13.9%	12.4%

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
07 February 2025