GLP-1 receptor agonists show effects on substance disorders, infections
Researchers should examine the effects of glucagon-like peptide 1 (GLP-1) receptor agonists on multiple diseases, according to the authors of a systematic review that looked at 175 health outcomes in patients taking diabetes medications.
Use of glucagon-like peptide 1 (GLP-1) receptor agonists was associated with a reduced risk of substance use and psychotic disorders, seizures, and neurocognitive disorders, but an increased risk of gastrointestinal disorders, hypotension, and arthritic disorders, compared to other antihyperglycemic drug classes, a study found.
To systematically evaluate the possible effects, risks, and health outcomes of these drugs, researchers used the U.S. Department of Veterans Affairs databases to compare a cohort of people with diabetes who took GLP-1 receptor agonists (n=215,970) with patients initiating sulfonylureas (n=159,465), dipeptidyl peptidase-4 (DPP-4) inhibitors (n=117,989), or sodium-glucose cotransporter-2 (SGLT-2) inhibitors (n=258,614), a group of patients taking any of the non-GLP-1 drugs (n=536,068), and 1,203,097 patients who continued usual care and did not initiate any of these drugs. Patients were followed for a median of 3.68 years, resulting in 7,239,854 person-years of follow-up. Researchers mapped associations of GLP-1 receptor agonist use versus each comparator with 175 health outcomes. Results were published Jan. 20 by Nature Medicine.
Compared to usual care, adding a GLP-1 receptor agonist was associated with a decreased risk of 42 (24.00%) outcomes and an increased risk of 19 (10.86%) outcomes. There was no statistically significant association for 114 studied outcomes. GLP-1 receptor agonists were associated with a reduced risk of substance use and psychotic disorders, seizures, neurocognitive disorders (including Alzheimer's disease and dementia), coagulation disorders, cardiometabolic disorders, infectious illnesses, and several respiratory conditions, while there was an increased risk of gastrointestinal disorders, hypotension, syncope, arthritic disorders, nephrolithiasis, interstitial nephritis, and drug-induced pancreatitis.
Future investigations should evaluate the drugs' effects on multimorbidity, the study authors said. “Overall, our results extended the body of evidence on the potential utility of GLP-1RAs [receptor agonists] in neuropsychiatric disorders and suggest the need to further evaluate the biology and effectiveness of GLP-1RAs as either a primary or adjuvant therapeutic for use in the management of various substance use disorders, psychotic disorders and depressive disorders,” they wrote.