Glucagon-like peptide 1 receptor agonist drugs (GLP-1RAs) – better known by their commercial names such as Ozempic, Wegovy or Mounjaro – used in the treatment of diabetes and obesity have represented a revolution in control. of the weight. Now, a new observational study published by Nature Medicine has revealed different health effects of these medications, both positive – such as less risk of developing neurocognitive and cardiometabolic disorders – and negative, for example, a greater risk of suffering from gastrointestinal disorders or hypotension. .
Researchers used the US Department of Veterans Affairs databases to analyze data from more than 215,000 people with diabetes who started using GLP-1RA. They compared the results with other groups of patients who had followed alternative treatments, such as sulfonylureas, dipeptidyl peptidase 4 (DPP4) inhibitors or sodium-glucose cotransporter type 2 (SGLT2) inhibitors. They also included control groups with people who followed standard diabetes treatments, without using GLP-1RA.
Lights and shadows of new anti-obesity drugs
The study looked at how GLP-1RA use was related to 175 different health problems. The results showed that, compared to traditional treatments, the use of GLP-1RA was linked to a lower risk of disorders such as addictions, psychosis, seizures, neurocognitive diseases (including Alzheimer’s and dementia), coagulation disorders, cardiometabolic diseases, infections and some respiratory conditions.
However, an increased risk of gastrointestinal problems, low blood pressure, fainting, arthritis, kidney stones, kidney inflammation, and drug-induced pancreatitis was also seen. These findings provide valuable information about the benefits and risks of these medications and may be useful both to improve medical care and to guide future research.
“Investigators compare event rates in GLP-1 agonist users with those seen in patients selected for other diabetes treatments. Instead of testing previous hypotheses about the benefits and harms of these new drugs, analysts look for patterns in the data that may indicate previously unknown effects. Some of the beneficial effects seen in their data, especially in neuropsychiatric and substance abuse disorders, are supported by other studies. Some could be related to improvements in weight control and metabolism, well-known effects of these medications. Others could be due to chance or bias, due to differences between the groups of patients chosen to start different treatments for diabetes,” David Henry, honorary adjunct professor at the Faculty of Science and Medicine of the Institute for Diabetes, explained in statements to SMC Spain. Evidence-Based Health Care from Bond University, the University of New South Wales and the University of Melbourne (Australia), which was not involved in the study.
“Importantly, the group that took the drug showed a lower incidence of schizophrenia, alcohol and drug use disorders, and less suicidal ideation.”
In the opinion of Stephen O’Rahilly, professor of Clinical Biochemistry and Medicine and director of the Wellcome-MRC Institute of Metabolic Science-Metabolic Research Laboratories at the University of Cambridge (United Kingdom): “The expected benefits in cardiovascular diseases, strokes and Other heart and kidney diseases are clearly evident. There is also a reassuring reduction in the incidence of several types of cancer, including pancreatic cancer. Importantly, since there have been discussions in the media about possible adverse effects of these medications on mental health, the group taking the drug showed a lower incidence of schizophrenia, alcohol and drug use disorders, and less suicidal ideation ”.
This expert warns that “studies like this one should be interpreted with great caution, since the people studied have not been randomly assigned to treatment with GLP-1 receptor agonists, so any difference between those who take and do not take this class of medications “It could be attributable to factors other than the drug.”
However, he notes that “overall, the results of this study, which followed more than 200,000 people with diabetes treated with GLP1RAs and compared them with more than 1.5 million people on other diabetes treatments, are reassuring in that to the risk/benefit ratio of long-term use of GLP1RAs in people with diabetes. Future studies on people treated with these medications for obesity, without accompanying diabetes, are awaited with interest.”
