GLP-1 Receptor Agonists and Neurological Outcomes in Patients With Brain Tumors: A Real-world Propensity-matched Cohort Study
Seerat Sachdeva1, Rudra Pratap Singh2, Iffat Ara Suchita1
1Department of Neurology, 2Department of Internal Medicine, University of New Mexico
Objective:
To evaluate whether GLP-1 receptor agonist (GLP-1RA) therapy is associated with improved neurological outcomes, including mortality, seizure incidence, and ICU admissions in adults with primary brain tumors.
Background:
GLP-1RAs have demonstrated neuroprotective and anti-inflammatory effects beyond glycemic control. However, their impact on clinical outcomes in patients with primary brain tumors has not been well studied, and real-world evidence is lacking.
Design/Methods:
We conducted a retrospective cohort study using the TriNetX Global Research Network. Adults (≥18 years) with type 2 diabetes, chronic kidney disease, obesity, or metabolic syndrome and a diagnosis of primary brain tumors (ICD-10 C71.x, Z85.841) were identified. Patients receiving GLP-1RAs (n = 1,814) were compared with propensity score–matched controls not on these agents (n = 1,777 per group after 1:1 matching). Matching accounted for demographics, comorbidities, and concurrent anti-diabetic therapies. Outcomes included all-cause mortality, ICU admission, and seizure incidence, analyzed using Kaplan-Meier survival curves and risk ratio models.
Results:
GLP-1RA use was associated with lower mortality (8.2% vs 33.1%; RR 0.25; 95% CI 0.21–0.29; p < 0.001), fewer ICU admissions (5.3% vs 14.8%; RR 0.36; 95% CI 0.28–0.46; p < 0.001), and reduced seizures (4.9% vs 15.5%; RR 0.32; 95% CI 0.24–0.42; p < 0.001). Kaplan-Meier analysis demonstrated improved cumulative survival among GLP-1RA users (log-rank p < 0.001). Benefits were found to be consistent across sex and metabolic subgroups.
Conclusions:
In adults with primary brain tumors, use of GLP-1RA is associated with reduced mortality, lower seizure burden, and decreased critical-care utilization. These findings highlight potential neuro-metabolic and neuro-protective effects of GLP-1RAs. In addition, addresses a critical knowledge gap in neuro-oncology by identifying a novel, potentially disease-modifying adjunctive therapy. However, further systematic studies are needed to confirm the efficacy, determine optimal dosing, and evaluate the safety of GLP-1 receptor agonists in patients with brain tumors.
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