Computational research conducted by scientists from Washington University in St. Louis shows that GLP-1 agonists can have mental and cognitive health benefits but may also harm the kidneys and pancreas.
A study published Monday in Nature Medicine reaffirmed the growing consensus that the benefits of GLP-1 agonists like Wegovy and Ozempic might extend beyond protecting against diabetes or aiding in weight loss.
Using a Department of Veterans Affairs database, researchers at Washington University in St. Louis tracked more than 215,000 patients using GLP-1 medications over a period of about four years. The authors then cross-referenced 175 other health outcomes experienced by those patients, compared them to patients taking other types of medications used for treating diabetes—such as DPP4 inhibitors— and looked for areas outside of diabetes where GLP-1 patients experienced benefits and side effects. The total cohort of patients, including all controls, was nearly 2 million, with 7 million years of life data in total.
“Given the drugs’ newness and skyrocketing popularity, it is important to systematically examine their effects on all body systems—leaving no stone unturned—to understand what they do and what they don’t do,” Ziyad Al-Aly, the study’s lead author, said in a statement.
Some of the negative side effects were hypotension, arthritis, a variety of kidney disorders and pancreatitis. Some of these negatives were previously known, but effects on the pancreas and kidneys were novel discoveries. The benefits, on the other hand, came in areas like reduced substance abuse risk, lowered risk of developing Alzheimer’s disease and other types of neurocognitive decline, heart conditions and several respiratory conditions like pneumonia, bronchitis and chronic obstructive pulmonary disease. There was even a reduction in suicidal ideation.
This study follows other similar research that showed a reduced risk of alcohol and tobacco consumption, as well as reduced risk of psychosis and other mental health disorders. Al-Aly pointed directly to the ability of GLP-1s to act on receptors in the brain to explain these effects.
Although the effect sizes for these benefits were generally small—between 10% and 20% for the most part—that doesn’t mean they’re not medically important, according to the authors.
“The modest effect does not negate the potential value of these drugs, especially for conditions where few effective treatment options exist, for example, dementia,” Al-Aly said.
“This may also imply that these drugs are most beneficial when used in conjunction with other interventions, such as lifestyle changes or other medications,” he added.
Certainly, the therapeutic reach of GLP-1s is already expanding, with recent approvals for reduction of cardiovascular events and sleep apnea, and several companies exploring their potential to treat chronic kidney disease, Alzheimer’s, Parkinson’s disease and more.
