Susan P Mollan1, Abd A Tahrani1, Alexandra J Sinclair1. 1. Birmingham Neuro-Ophthalmology (SPM), Queen Elizabeth Hospital; Institute of Metabolism and Systems Research (AAT), College of Medical and Dental Sciences, University of Birmingham; Department of Diabetes and Endocrinology (AAT), Queen Elizabeth Hospital, Birmingham; Metabolic Neurology (AJS), Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham; and Department of Neurology (AJS), University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, United Kingdom.
Abstract
PURPOSE OF REVIEW: Idiopathic intracranial hypertension (IIH) prevalence increased in conjunction with rising obesity rates. Here, we highlight the importance of weight management in IIH and introduce glucagon-like peptide 1 (GLP-1) receptor agonists (RAs) as potential treatment strategy for IIH. RECENT FINDINGS: Weight gain is a risk factor for IIH, and weight loss (via any treatment strategy) plays a key role in IIH management. GLP-1 is an incretin secreted by the distal small intestine in response to a meal. GLP-1 RAs have been shown to improve glycaemic control (no hypoglycaemia) and lower body weight in patients with and without type 2 diabetes. The choroid plexus has been found to express GLP-1 receptors, and treatment with a GLP-1 RA significantly reduces CSF secretion in vitro and intracranial pressure (ICP) in rodents. SUMMARY: New research evaluating the pathophysiology of IIH supports GLP-1 RA as a potential treatment for IIH via weight loss dependent and independent mechanism to directly reduce ICP.
PURPOSE OF REVIEW: Idiopathic intracranial hypertension (IIH) prevalence increased in conjunction with rising obesity rates. Here, we highlight the importance of weight management in IIH and introduce glucagon-like peptide 1 (GLP-1) receptor agonists (RAs) as potential treatment strategy for IIH. RECENT FINDINGS: Weight gain is a risk factor for IIH, and weight loss (via any treatment strategy) plays a key role in IIH management. GLP-1 is an incretin secreted by the distal small intestine in response to a meal. GLP-1 RAs have been shown to improve glycaemic control (no hypoglycaemia) and lower body weight in patients with and without type 2 diabetes. The choroid plexus has been found to express GLP-1 receptors, and treatment with a GLP-1 RA significantly reduces CSF secretion in vitro and intracranial pressure (ICP) in rodents. SUMMARY: New research evaluating the pathophysiology of IIH supports GLP-1 RA as a potential treatment for IIH via weight loss dependent and independent mechanism to directly reduce ICP.
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