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The following is a summary of “Treatment of Hypothalamic Obesity With GLP-1 Analogs,” published in the November 2024 issue of Endocrinology by Dimitri and Roth.
Damage to hypothalamic nuclei or satiety-regulating neuronal circuits led to hypothalamic obesity (HO), with limited success in achieving weight loss and satiety through drug trials.
Researchers conducted a retrospective study to explore the potential of Glucagon-like peptide-1 (GLP-1) via GLP-1 receptor agonists (GLP-1RAs) as an alternative treatment for HO.
They reviewed studies published between January 2005 and February 2024, searching Medline, Google Scholar, and clinical trial registries (ClinicalTrials.gov; clinicaltrialsregister.eur) using PubMed and Embase databases. The keywords included GLP-1, GLP-1RAs, HO, suprasellar tumor, and craniopharyngioma.
The results showed 7 case studies, 5 case series, and 2 clinical trials on GLP-1RAs in HO. All case studies indicated weight loss and improved metabolic function. Case series showed mixed results, with some reporting no weight loss and others demonstrating moderate to significant weight loss and metabolic improvements. In the ECHO clinical trial, nearly 50% of subjects receiving weekly exenatide showed reduced body mass index (BMI). Interestingly, BMI reduction was more pronounced in individuals with extensive hypothalamic injuries.
Investigators concluded the GLP-1RAs might offer a novel therapeutic avenue for hypertrophic cardiomyopathy, however, patient stratification and further randomized controlled trials are necessary to establish their efficacy, either as monotherapy or in combination with existing treatments.
Source: academic.oup.com/jes/article/9/1/bvae200/7900020
