Testing GLP-1 Receptor Agonists for Other Cardiovascular and Stroke-Related Conditions: Dennis Rivet, MD

"For secondary stroke prevention, our current tools are effective, but limited. GLP-1 agonists may represent a way to meaningfully reduce risk in this high-need population."

Idiopathic intracranial hypertension (IIH) is characterized by raised intracranial pressure without a clear mass lesion or hydrocephalus, often in young women with obesity. Weight loss has consistently been shown to improve IIH symptoms and disease course, leading to greater conversations about testing glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in cardiovascular and stroke conditions like IIH. One recent study, led by Dennis Rivet, MD, showed that GLP-1 RAs were associated with significant reductions in medication use, symptoms/signs, and procedural interventions in patients with IIH, further supporting the potential role of these medications as a management strategy.

The study originally identified more than 44,000 patients with IIH, and after matching, included 555 GLP-1 RA users and 555 nonusers. Rivet, who serves as the Harold I. Nemuth Chair in Neurological Disorders at Virginia Commonwealth University, noted that while the findings were incredibly encouraging, there needs more structured, larger-scale studies to confirm the findings to truly understand the impact of GLP-1 RAs in the population.

In an interview with NeurologyLive®, Rivet answered questions about the broader use of these medications beyond IIH, noting their potential role in secondary stroke prevention, where current strategies like antiplatelet therapy and statins have high numbers needed to treat. In addition, Rivet touched on mounting evidence that GLP-1 therapies rapidly reduce inflammatory markers, raising the possibility of benefits in conditions such as psoriatic arthritis and other inflammatory diseases. While still speculative, the ideas discussed cover the expanding therapeutic horizon for GLP-1 agents in neurology and systemic health.