LOS ANGELES– Newer glucose-lowering drugs minimize the threat for late-onset seizures and epilepsy by 24%, with glucagon-like peptide 1 receptor agonists (GLP-1 RAs) cutting the threat by 33%, according to a brand-new meta-analysis.
These outcomes are “remarkable” thinking about there are presently no drugs that really avoid epilepsy, lead research study author Udeept Sindhu, MD, junior citizen, Kasturba Medical College, Manipal, India, informed Medscape Medical News
Udeept Sindhu, MD
This type of research study might add to “lowering the epilepsy problem worldwide,” stated Sindhu.
The findings existed on December 9, 2024, at the American Epilepsy Society (AES) 78th Annual Meeting 2024 and released online last month in Epilepsia Open
The private investigators took a look at late-onset seizures and epilepsy (specified as detected after age 55 years) in 3 classes of glucose-lowering drugs: GLP-1 RAs, dipeptidyl peptidase 4 (DPP-4) inhibitors, and sodium-glucose transportation protein 2 (SGLT2) inhibitors.
While not “brand name brand-new,” these glucose-lowering drugs were presented in between 2000 and 2010 and represent “modern-day advances” compared to older medications such metformin and sulfonylureas, stated Sindhu. He included these “more recent” representatives are more apt to reduce neuroinflammation.
The meta-analysis consisted of 27 randomized regulated trials of these drugs with an overall population of 197,910 grownups (102,939 randomized to get the drug and 94,971 randomized to get placebo). The analysis consisted of 5 trials for DPP-4 inhibitors, 8 for GLP-1 RAs, and 14 for SGLT2 inhibitors. The earliest trial remained in 2013 and the most current in 2023.
The research studies examined cardiovascular and kidney results and reported seizure or epilepsy as unfavorable occasions.
The 3 classes of drugs together decreased the threat for epilepsy and seizures (integrated) by 24% (danger ratio [RR]0.76; 95% CI, 0.62-0.95).
Taking a look at the classes separately, the RRs were 0.67 (95% CI, 0.46-0.98) for GLP-1 RAs, 0.74 (95% CI, 0.46-1.20) for DPP-4 inhibitors, and 0.85 (95% CI, 0.62-1.17) for SGLT2 inhibitors.
When examining results for epilepsy and seizures independently, there was a substantial seizure danger decrease with GLP-1 RAs, however the outcomes did not reach significance for epilepsy. This may be due to fairly brief research study periods or meanings of epilepsy utilized, stated Sindhu.
The typical follow-up in the research studies had to do with 2.5 years, throughout which time more clients were identified with a seizure than with epilepsy. And it's uncertain if the examined research studies utilized the International League Against Epilepsy's meaning of epilepsy (2 unprovoked seizures or one unprovoked seizure with a previous brain injury), stated Sindhu.
As the combined results of seizures and epilepsy were considerable, and due to encouraging preclinical information, “we propose these drugs may have anti-epileptogenic impacts,” he stated.
The most likely system for these impacts is through the general cerebrovascular effect of these drugs, stated Sindhu. “The most typical reason for seizure and epilepsy in older grownups is cerebrovascular illness, followed by neurodegenerative pathology.”
He kept in mind these medications have actually been revealed to lower the threat for all-cause dementia,
