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Abstract Details

GLP-1 Receptor Agonist Use Associated With Greater Physical Activity and Improved Patient-reported Outcomes in Multiple Sclerosis: A Single-site Retrospective Cohort Study
Multiple Sclerosis
P1 - Poster Session 1 (8:00 AM-9:00 AM)
20-009
To assess whether initiation of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) was associated with changes in exercise activity and patient-reported outcomes (PROs) in people with multiple sclerosis (MS).
GLP-1 RAs, used for type 2 diabetes and obesity, have plausible central nervous system effects on neuroinflammation, energy, balance, fatigue, and mood, which may influence MS symptoms and improve physical activity.
We conducted a retrospective observational cohort study of MS patients treated with GLP-1 RA’s. Pharmacy and medication administration records identified GLP-1 RA initiation dates. We extracted self-reported physical activity (minutes/week of moderate-to-vigorous physical activity) and SymptoMScreen PROs, (13 domains, 0–6 scale) collected routinely during visits at the last MS center visit prior to initiation and compared to visits ≥6 months after. Patients without data for either visit were excluded; those treated with multiple GLP-1 RAs were included only for their first exposure. Paired within-person comparisons assessed pre- and post-exposure changes.
Seventy patients were included (mean age 51.3 years, 87% female, median EDSS 2.5 [IQR 1.0–4.5]). Follow-up visits were 7.2 months (218 days) after initiation of GLP-1 RA on average. Physical activity increased from 52.3 to 115.7 minutes/week after GLP-1RA initiation (mean change +65.8, 95% CI +48.5 to +83.0, p<0.001). Significant improvements were observed in anxiety (–0.65), bowel dysfunction (–0.52), bladder dysfunction (–0.64), and sensory symptoms (–0.54), all p<0.001. Smaller but significant improvements noted in body pain (–0.48, p=0.004), vision (–0.31, p=0.04), spasticity (–0.28, p=0.03), and dizziness (–0.39, p=0.02). No significant changes were seen in walking, hand function, fatigue, cognition, or depression.
GLP-1 RA initiation in MS was associated with greater physical activity and improvements in several PRO domains, further supporting association of metabolic health with MS outcomes and need for prospective studies to validate these findings.
Authors/Disclosures
Karl Heward, MD
PRESENTER 		Dr. Heward has nothing to disclose.
Gloria Hou, MD Dr. Hou has nothing to disclose.
Sarah B. Simmons, MD, PhD (Cleveland Clinic Foundation - Cleveland, Oh) The institution of Dr. Simmons has received research support from National Multiple Sclerosis Society.
Edward Kim, MD Dr. Kim has nothing to disclose.
Michael J. Persenaire, MD (University of Washington) Dr. Persenaire has nothing to disclose.
Evan Madill, MD (Mass General Brigham) The institution of Dr. Madill has received research support from 好色先生.
Yujie Wang, MD (UW Northwest) Dr. Wang has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. The institution of Dr. Wang has received research support from Genentech. The institution of Dr. Wang has received research support from uniQure. The institution of Dr. Wang has received research support from NIH/NINDS.
Gloria Von Geldern, MD, FAAN (University of Washington) The institution of Dr. Von Geldern has received research support from Novartis. The institution of Dr. Von Geldern has received research support from Contineum Therapeutics. Dr. Von Geldern has received personal compensation in the range of $0-$499 for serving as a DSMB member with NIH, NINDS. Dr. Von Geldern has a non-compensated relationship as a editorial board member with MS and Related Disorders Journal that is relevant to AAN interests or activities.
Annette Wundes, MD, FAAN (University of Washington) The institution of Dr. Wundes has received research support from Benaroya Research Institute .
Shuvro Roy, MD (University of Washington) Dr. Roy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Roy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Roy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Roy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. The institution of Dr. Roy has received research support from The Siegel Rare Neuroimmune Association.