Newer Diabetes Drugs May Reduce Brain Pressure, Vision Loss

Newer drugs for diabetes have been praised for improved management of blood sugar, while also inducing weight loss, a common problem for patients with type 2 diabetes.

GLP-1 agonists, which are commonly used to treat patients with obesity or type 2 diabetes, have been found to also lower brain pressure, according to a study published by Science Translational Medicine.

Heightened brain pressure is involved with emergency situations, such as traumatic brain injury, hydrocephalus, and stroke. The condition is also a feature of idiopathic intracranial hypertension (IIH), which causes headaches, raises pressure around the nerves in the eyes, and causes blindness in 25% of untreated patients.

In the 3-year study, the authors evaluated whether GLP-1 agonists could reduce intracranial pressure in animal models of increased brain pressure.

“Treatments to lower brain pressure are lacking and new treatments are desperately needed,” said corresponding author Alexandra Sinclair, PhD. “The current primary treatment in IIH is acetazolamide and this does not work well for many patients, while also having such severe side effects that our previous trials have shown that 48% of patients stop taking it.”

The authors found that treatment with GLP-1 agonists may provide significant benefits to patients with heightened brain pressure and avert serious adverse events.

“We have shown that the GLP-1 agonist extendin-4 significantly reduces brain pressure rapidly and dramatically, by around 44% with significant effects from just 10 minutes of dosing — the biggest reduction we have seen in anything we have previously tested,” Dr Sinclair said. “What’s more, we found that the effects last at least 24 hours.”

Importantly, since GLP-1 agonists are already approved to treat patients with type 2 diabetes and obesity, the drugs have been found safe in humans. Additionally, GLP-1 agonists may also be brought to the market sooner for a new indication compared with experimental compounds.

“These findings are rapidly translatable into a new novel treatment strategy for IIH, as GLP-1 agonists are safe and widely-used drugs used to treat diabetes and obesity,” Dr Sinclair said. “They are also potentially game-changing for other conditions featuring raised brain pressure, including stroke, hydrocephalus and traumatic brain injury.”

The authors plan to start a clinical trial of GLP-1 agonists in patients with increased brain pressure, according to the study.

“We are very excited that this novel treatment strategy could make a landmark change for future patient care,” Dr Sinclair concluded.