PMID- 37460968
OWN - NLM
STAT- MEDLINE
DCOM- 20230719
LR  - 20230720
IS  - 1129-2377 (Electronic)
IS  - 1129-2369 (Print)
IS  - 1129-2369 (Linking)
VI  - 24
IP  - 1
DP  - 2023 Jul 18
TI  - Treatment with GLP-1 receptor agonists is associated with significant weight loss 
      and favorable headache outcomes in idiopathic intracranial hypertension.
PG  - 89
LID - 10.1186/s10194-023-01631-z [doi]
LID - 89
AB  - BACKGROUND: In idiopathic intracranial hypertension (IIH), sustained weight loss 
      is the main pillar in modifying disease course, whereby glucagon-like peptide-1 
      receptor agonists (GLP-1-RAs) could present an attractive treatment option. 
      METHODS: In this open-label, single-center, case-control pilot study, patients 
      with IIH (pwIIH) and a body mass index (BMI) of >/= 30 kg/m(2) were offered to 
      receive a GLP-1-RA (semaglutide, liraglutide) in addition to the usual care 
      weight management (UCWM). Patients electing for UCWM only served as a control 
      group matched for age-, sex- and BMI (1:2 ratio). The primary endpoint was the 
      percentage weight loss at six months (M6) compared to baseline. Secondary 
      endpoints included the rate of patients with a weight loss of >/= 10%, monthly 
      headache days (MHD), the rate of patients with a >/= 30% and >/= 50% reduction in 
      MHD, visual outcome parameters, and adverse events (AEs). RESULTS: We included 39 
      pwIIH (mean age 33.6 years [SD 8.0], 92.3% female, median BMI 36.3 kg/m(2) [IQR 
      31.4-38.3]), with 13 patients being treated with GLP-1-RAs. At M6, mean weight 
      loss was significantly higher in the GLP-1-RA group (-12.0% [3.3] vs. -2.8% 
      [4.7]; p < 0.001). Accordingly, weight loss of >/= 10% was more common in this 
      group (69.2% vs. 4.0%; p < 0.001). Median reduction in MHD was significantly 
      higher in the GLP-1-RA group (-4 [-10.5, 0.5] vs. 0 [-3, 1]; p = 0.02), and the 
      50% responder rate was 76.9% vs. 40.0% (p = 0.04). Visual outcome parameters did 
      not change significantly from baseline to M6. Median reduction in acetazolamide 
      dosage was significantly higher in the GLP-1-RA group (-16.5% [-50, 0] vs. 0% 
      [-25, 50]; p = 0.04). AEs were mild or moderate and attributed to 
      gastrointestinal symptoms in 9/13 patients. None of the AEs led to premature 
      treatment discontinuation. CONCLUSIONS: This open-label, single-center pilot 
      study suggests that GLP-1-RAs are an effective and safe treatment option for 
      achieving significant weight loss with a favorable effect on headache, leading to 
      reduced acetazolamide dosage in pwIIH.
CI  - (c) 2023. The Author(s).
FAU - Krajnc, Nik
AU  - Krajnc N
AD  - Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 
      1090, Vienna, Austria.
AD  - Comprehensive Center for Clinical Neurosciences, Medical University of Vienna, & 
      Mental Health, Vienna, Austria.
FAU - Itariu, Bianca
AU  - Itariu B
AD  - Department of Internal Medicine III, Division of Endocrinology, Medical 
      University of Vienna, Vienna, Austria.
FAU - Macher, Stefan
AU  - Macher S
AD  - Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 
      1090, Vienna, Austria.
AD  - Comprehensive Center for Clinical Neurosciences, Medical University of Vienna, & 
      Mental Health, Vienna, Austria.
FAU - Marik, Wolfgang
AU  - Marik W
AD  - Comprehensive Center for Clinical Neurosciences, Medical University of Vienna, & 
      Mental Health, Vienna, Austria.
AD  - Department of Neuroradiology and Musculoskeletal Radiology, Medical University of 
      Vienna, Vienna, Austria.
FAU - Harreiter, Jurgen
AU  - Harreiter J
AD  - Department of Internal Medicine III, Division of Endocrinology, Medical 
      University of Vienna, Vienna, Austria.
FAU - Michl, Martin
AU  - Michl M
AD  - Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
FAU - Novak, Klaus
AU  - Novak K
AD  - Comprehensive Center for Clinical Neurosciences, Medical University of Vienna, & 
      Mental Health, Vienna, Austria.
AD  - Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
FAU - Wober, Christian
AU  - Wober C
AD  - Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 
      1090, Vienna, Austria.
AD  - Comprehensive Center for Clinical Neurosciences, Medical University of Vienna, & 
      Mental Health, Vienna, Austria.
FAU - Pemp, Berthold
AU  - Pemp B
AD  - Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
FAU - Bsteh, Gabriel
AU  - Bsteh G
AD  - Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 
      1090, Vienna, Austria. gabriel.bsteh@meduniwien.ac.at.
AD  - Comprehensive Center for Clinical Neurosciences, Medical University of Vienna, & 
      Mental Health, Vienna, Austria. gabriel.bsteh@meduniwien.ac.at.
LA  - eng
PT  - Journal Article
DEP - 20230718
PL  - England
TA  - J Headache Pain
JT  - The journal of headache and pain
JID - 100940562
RN  - 0 (Glucagon-Like Peptide-1 Receptor)
RN  - O3FX965V0I (Acetazolamide)
RN  - 89750-14-1 (Glucagon-Like Peptide 1)
SB  - IM
MH  - Humans
MH  - Female
MH  - Adult
MH  - Male
MH  - *Pseudotumor Cerebri/complications/drug therapy
MH  - Glucagon-Like Peptide-1 Receptor/agonists
MH  - Acetazolamide
MH  - Pilot Projects
MH  - Glucagon-Like Peptide 1
MH  - Headache/complications
MH  - Weight Loss
PMC - PMC10353241
OTO - NOTNLM
OT  - Glucagon-like peptide-1
OT  - Headache
OT  - Idiopathic intracranial hypertension
OT  - Visual worsening
OT  - Weight loss
COIS- Nik Krajnc: has participated in meetings sponsored by, received speaker honoraria 
      or travel funding from BMS/Celgene, Janssen-Cilag, Merck, Novartis, Roche and 
      Sanofi-Genzyme and held a grant for a Multiple Sclerosis Clinical Training 
      Fellowship Programme from the European Committee for Treatment and Research in 
      Multiple Sclerosis (ECTRIMS). Bianca Itariu: declares no conflict of interest 
      relevant to this study. Stefan Macher: declares no conflict of interest relevant 
      to this study. Wolfgang Marik: declares no conflict of interest relevant to this 
      study. Jurgen Harreiter: has participated in meetings sponsored by, received 
      speaker/consultancy honoraria or travel funding from Novo Nordisk, Sanofi, 
      Novartis, Eli Lilly, Boehringer-Ingelheim. He has received unrestricted research 
      grants from Bayer and Astra Zeneca. Martin Michl: declares no conflict of 
      interest relevant to this study. Klaus Novak: declares no conflict of interest 
      relevant to this study. Christian Wober: has received honoraria 
      consultancy/speaking from Apomedica, Curelator, Eli Lilly, Grunenthal, Hermes, 
      Lundbeck, Novartis, Pfizer, Ratiopharm/Teva, and Stada. Berthold Pemp: declares 
      no conflict of interest relevant to this study. Gabriel Bsteh: has participated 
      in meetings sponsored by, received speaker honoraria or travel funding from 
      Biogen, Celgene/BMS, Lilly, Merck, Novartis, Roche, Sanofi-Genzyme and Teva, and 
      received honoraria for consulting Biogen, Celgene/BMS, Novartis, Roche, 
      Sanofi-Genzyme and Teva. He has received unrestricted research grants from 
      Celgene/BMS and Novartis.
EDAT- 2023/07/18 01:09
MHDA- 2023/07/19 06:42
PMCR- 2023/07/18
CRDT- 2023/07/17 23:42
PHST- 2023/05/31 00:00 [received]
PHST- 2023/07/13 00:00 [accepted]
PHST- 2023/07/19 06:42 [medline]
PHST- 2023/07/18 01:09 [pubmed]
PHST- 2023/07/17 23:42 [entrez]
PHST- 2023/07/18 00:00 [pmc-release]
AID - 10.1186/s10194-023-01631-z [pii]
AID - 1631 [pii]
AID - 10.1186/s10194-023-01631-z [doi]
PST - epublish
SO  - J Headache Pain. 2023 Jul 18;24(1):89. doi: 10.1186/s10194-023-01631-z.