Multiple sclerosis patients taking glucagon-like peptide-1 receptor (GLP-1) agonists: a single-institution retrospective cohort study of tolerability and weight loss.

Autor: Udawatta M; Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.; Department of Neurology, Massachusetts General Hospital, 165 Cambridge Street, #627, Boston, MA, 02114, USA.; Harvard Medical School, Boston, MA, USA., Fidalgo N; Department of Neurology, Massachusetts General Hospital, 165 Cambridge Street, #627, Boston, MA, 02114, USA.; John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA., Mateen FJ; Department of Neurology, Massachusetts General Hospital, 165 Cambridge Street, #627, Boston, MA, 02114, USA. fmateen@mgh.harvard.edu.; Harvard Medical School, Boston, MA, USA. fmateen@mgh.harvard.edu.
Jazyk: angličtina
Zdroj: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology [Neurol Sci] 2025 Jan; Vol. 46 (1), pp. 343-349. Date of Electronic Publication: 2024 Jul 20.
DOI: 10.1007/s10072-024-07701-7
Abstrakt: 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/m 2 (range 25.9, 58.9 kg/m 2 ; n = 43 clinically obese or BMI > 30 kg/m 2 ) 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.
Competing Interests: Ethics approval and reporting guidelines: This retrospective cohort study protocol was approved by the Mass General Brigham Institutional Review Board. Reporting of the study protocol follows the STROBE guidelines. [14] Disclosures/Perceived conflicts of interest: F. Mateen has received research funding from EMD Serono, Genentech, Horizon Therapeutics, Novartis, and TG Therapeutics, and has consulted for Alexion, EMD Serono, Genentech, and Horizon Therapeutics, all unrelated to this work. M. Udawatta and N. Fidalgo received no specific grants from any funding agency in the public, commercial, or not-for-profit sectors.
(© 2024. Fondazione Società Italiana di Neurologia.)
Databáze: MEDLINE
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