Efficacy of GLP1-RA in the Treatment of Idiopathic Intracranial Hypertension: A Retrospective Cohort Study

Introduction: Idiopathic intracranial hypertension (IIH) is a disorder characterized by elevated intracranial pressure (ICP) without an identifiable cause, predominantly affecting women of childbearing age and often linked to obesity. Current treatments, such as acetazolamide and weight loss, are associated with limited efficacy and significant side effects. Glucagon-like peptide-1 receptor agonists (GLP1-RA), which promote weight loss and metabolic regulation, have shown promise as a novel therapeutic approach for IIH.

Methods: This retrospective cohort study utilized data from the TriNetX database, analyzing patients diagnosed with IIH. Patients were categorized into two cohorts: those who initiated GLP1-RA therapy within six months of diagnosis and those who never received GLP1-RA. Propensity score matching (PSM) was applied to balance demographic and clinical characteristics, and outcomes such as headache frequency, visual disturbances, papilledema, and acetazolamide use were assessed.

Results: After matching, 199 patients were included in each cohort. The GLP1-RA group had significantly fewer headaches (9% vs. 25.6%, RR 0.353, p< 0.001) and visual disturbances (0.5-5% vs. 17.1%, RR 0.294, p< 0.001) compared to the control group. Additionally, acetazolamide use was lower in the GLP1-RA group (8.5% vs. 23.1%, RR 0.370, p< 0.001).

Conclusion : GLP1-RA therapy appears to significantly reduce key symptoms of IIH, including headaches and visual disturbances, while decreasing the need for acetazolamide. These findings suggest GLP1-RAs may offer a promising new therapeutic option for patients with IIH by addressing the underlying metabolic dysfunction associated with the condition. More studies are needed.