Multiple sclerosis patients taking glucagon-like peptide-1 receptor (GLP-1) agonists: a single-institution retrospective cohort study of tolerability and weight loss.
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| Title: | Multiple sclerosis patients taking glucagon-like peptide-1 receptor (GLP-1) agonists: a single-institution retrospective cohort study of tolerability and weight loss. |
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| Authors: | Udawatta, Methma (AUTHOR), Fidalgo, Nicholas (AUTHOR), Mateen, Farrah J. (AUTHOR) |
| Source: | Neurological Sciences. Jan2025, Vol. 46 Issue 1, p343-349. 7p. |
| Subjects: | Glucagon-like peptide-1 receptor, Glucagon-like peptide-1 agonists, Weight loss, Body mass index, Interferon beta-1a |
| Abstract: | Obesity is a risk factor for developing and worsening multiple sclerosis (MS) and is often comorbid with MS, exacerbating disability. We retrospectively studied MS patients starting glucagon-like peptide-1 (GLP-1) agonists at the [redacted for review] U.S.A. (January 2005-June 2024). Patients (n = 49) were mostly female (73%), average age 54 years old, with relapsing disease (78%) and an average starting body mass index (BMI) of 39.7 kg/m2 (range 25.9, 58.9 kg/m2; n = 43 clinically obese or BMI > 30 kg/m2) and weight of 110.6 kg (245.6 lbs.; range 68–155.8 kg, 150-343.4 lbs.). The most commonly taken disease modifying therapy (DMT) was ocrelizumab (39%) while 24% of patients were not taking any DMT. The most common comorbidities were hypertension (59%), hyperlipidemia (55%), and diabetes mellitus (41%). Patients took GLP-1 agonists for an average of 24.2 months (median 21.4; range 3.2, 88.5 months). Patients lost on average 0.47 kg/month (1.03 lbs./month; range of total weight change: 27.7 kg (61.1 lbs.) lost, 7.7 kg (17.0 lbs.) gained). Among overweight and obese patients with MS, those with a higher starting BMI tended to lose more weight. 29% experienced side effects of the GLP-1 drugs with 3 discontinuations due to tolerability. Four patients accrued new demyelinating lesions on MRI (one on no DMT, two started on a high-efficacy DMT for the first time in the past 6 months, and one on a high-efficacy DMT) and one patient experienced a new MS attack (treated with interferon beta-1a). Our early experience suggests GLP-1 agonists are safe in MS patients, who have a similar tolerability to the general population on this medication class and measurable and sustained but somewhat less than anticipated weight loss. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | Obesity is a risk factor for developing and worsening multiple sclerosis (MS) and is often comorbid with MS, exacerbating disability. We retrospectively studied MS patients starting glucagon-like peptide-1 (GLP-1) agonists at the [redacted for review] U.S.A. (January 2005-June 2024). Patients (n = 49) were mostly female (73%), average age 54 years old, with relapsing disease (78%) and an average starting body mass index (BMI) of 39.7 kg/m2 (range 25.9, 58.9 kg/m2; n = 43 clinically obese or BMI > 30 kg/m2) and weight of 110.6 kg (245.6 lbs.; range 68–155.8 kg, 150-343.4 lbs.). The most commonly taken disease modifying therapy (DMT) was ocrelizumab (39%) while 24% of patients were not taking any DMT. The most common comorbidities were hypertension (59%), hyperlipidemia (55%), and diabetes mellitus (41%). Patients took GLP-1 agonists for an average of 24.2 months (median 21.4; range 3.2, 88.5 months). Patients lost on average 0.47 kg/month (1.03 lbs./month; range of total weight change: 27.7 kg (61.1 lbs.) lost, 7.7 kg (17.0 lbs.) gained). Among overweight and obese patients with MS, those with a higher starting BMI tended to lose more weight. 29% experienced side effects of the GLP-1 drugs with 3 discontinuations due to tolerability. Four patients accrued new demyelinating lesions on MRI (one on no DMT, two started on a high-efficacy DMT for the first time in the past 6 months, and one on a high-efficacy DMT) and one patient experienced a new MS attack (treated with interferon beta-1a). Our early experience suggests GLP-1 agonists are safe in MS patients, who have a similar tolerability to the general population on this medication class and measurable and sustained but somewhat less than anticipated weight loss. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 15901874 |
| DOI: | 10.1007/s10072-024-07701-7 |
