Abstract Details

Title GLP-1 Receptor Agonists in the Management of Idiopathic Intracranial Hypertension: Evidence from a Nationwide Cohort

Topic Headache

Presentation(s) P6 - Poster Session 6 (5:00 PM-6:00 PM)

Poster/Presentation
Number 15-001

Objective To evaluate whether glucagon-like peptide 1 receptor agonist (GLP-1 RA) therapy provides clinical benefits in the management of idiopathic intracranial hypertension (IIH) compared with conventional treatments.

Background Current therapies for IIH, including acetazolamide, topiramate, and weight management strategies, are limited by side effects and incomplete efficacy. GLP-1 RAs, widely used for weight loss and metabolic regulation, have emerged as potential agents for IIH treatment, but evidence remains limited.

Design/Methods A retrospective cohort study was performed using electronic health records from the TriNetX US Collaborative Network (2005-2024). Adults aged 18 years or older with an IIH diagnosis were included. Patients initiating GLP-1 RA therapy within six months of diagnosis formed the exposure group, while controls received conventional therapies without GLP-1 RA use. Outcomes were assessed over a one-year follow-up. Propensity score matching was applied to balance baseline characteristics, and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated.

Results Among 44,373 patients with IIH, 603 received GLP-1 RAs and 43,770 did not. After matching, 555 patients remained in each group. Compared with controls, GLP-1 RA use was associated with reduced medication reliance (RR 0.53; 95% CI 0.46-0.61), headaches (RR 0.45; 95% CI 0.35-0.58), visual disturbances or blindness (RR 0.60; 95% CI 0.41-0.88), and papilledema (RR 0.19; 95% CI 0.10-0.34). Procedures (RR 0.44; 95% CI 0.30-0.63) and mortality (RR 0.36; 95% CI 0.18-0.73) were also lower. No significant differences in BMI were observed at one year. Findings were consistent across BMI subgroups. Bariatric surgery was associated with greater weight loss, but GLP-1 RA therapy was associated with better outcomes.

Conclusions GLP-1 RA therapy was associated with substantial improvements in clinical outcomes and reduced need for interventions in IIH. These results support GLP-1 RAs as a promising therapeutic option, meriting confirmation through prospective studies.

Authors/Disclosures
Georgios Sioutas, MD PRESENTER	Dr. Sioutas has nothing to disclose.
William Mualem, MD	Dr. Mualem has nothing to disclose.
John Reavey-Cantwell, MD	Dr. Reavey-Cantwell has nothing to disclose.
Caitlin Rivet, RN	Ms. Rivet has nothing to disclose.

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