Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
[Preprint]. 2024 Nov 13:2024.11.12.24317193.
doi: 10.1101/2024.11.12.24317193.

Efficacy of Tirzepatide Dual GIP/GLP-1 Receptor Agonist In Patients with Idiopathic Intracranial Hypertension. A Real-World Propensity Score-Matched Study

Ahmed Y Azzam  1   2 , Muhammed Amir Essibayi  1   2 , Nathan Farkas  3 , Mohammed A Azab  4 , Mahmoud M Morsy  5 , Osman Elamin  6 , Adam Elswedy  7 , Ahmed Saad Al Zomia  8 , Hammam A Alotaibi  9 , Ahmed Alamoud  8 , Oday Atallah  10 , Hana J Abukhadijah  11 , Adam A Dmytriw  12   13 , Amanda Baker  1   2 , Deepak Khatri  2 , Neil Haranhalli  2 , David J Altschul  1   2
Affiliations

Efficacy of Tirzepatide Dual GIP/GLP-1 Receptor Agonist In Patients with Idiopathic Intracranial Hypertension. A Real-World Propensity Score-Matched Study

Ahmed Y Azzam et al. medRxiv. .

Update in

Abstract

Introduction: Idiopathic intracranial hypertension (IIH) is a neurological disorder characterized by elevated intracranial pressure, predominantly affecting obese women of reproductive age. While GLP-1 receptor agonists have shown promise in IIH management, the potential of dual GIP/GLP-1 receptor activation through tirzepatide remains unexplored. This study aimed to evaluate tirzepatide's efficacy as an adjunctive therapy in IIH management.

Methods: We conducted a retrospective cohort analysis using the TriNetX Global Health Research Network, analyzing data through November 2024. Through propensity score matching, we compared 193 tirzepatide-exposed IIH patients with 193 controls receiving standard care. Primary outcomes included papilledema severity, visual function, headache frequency, and treatment resistance, monitored at multiple follow-up timepoints.

Results: Our analysis revealed significant improvements across all measured outcomes in the tirzepatide group. At 24 months, we observed a 68% reduction in papilledema risk (RR 0.320, 95% CI 0.189-0.542, p<0.001), a 73.9% reduction in visual disturbance and blindness risk (RR 0.261, 95% CI 0.143-0.477, p<0.001), and a 19.7% reduction in headache risk (RR 0.803, 95% CI 0.668-0.966, p=0.019). The tirzepatide group demonstrated significant body-mass index reductions, reaching -1.147 kg/m² (95% CI [-1.415, -0.879], p<0.001) at 24 months compared to controls.

Conclusions: Our results demonstrate that tirzepatide, when used as an adjunctive therapy, provides significant therapeutic benefits in IIH management, particularly in improving papilledema and visual outcomes. Our findings suggest that dual GIP/GLP-1 receptor activation may offer advantages over traditional single-receptor therapies, potentially through enhanced metabolic regulation and direct effects on intracranial pressure dynamics.

Keywords: Headache; Idiopathic Intracranial Hypertension; Papilledema; Pseudotumor Cerebri; Tirzepatide.

PubMed Disclaimer

Figures

Figure 1:
Figure 1:
Patients Enrollment Flow Diagram.
Figure 2:
Figure 2:
Risk Difference Longitudinal Analysis Over Timepoints For Outcomes.
See this image and copyright information in PMC

References

    1. Sheth S., et al., The protective role of GLP-1 in neuro-ophthalmology. 2023. 1(4): p. 221–238.
    1. Mitchell J.L., et al., The effect of GLP-1RA exenatide on idiopathic intracranial hypertension: a randomized clinical trial. 2023. 146(5): p. 1821–1830. - PMC - PubMed
    1. Zhou C., et al., Progress and recognition of idiopathic intracranial hypertension: A narrative review. 2024. 30(8): p. e14895. - PMC - PubMed
    1. Hornby C., et al., Metabolic Concepts in Idiopathic Intracranial Hypertension and Their Potential for Therapeutic Intervention. J Neuroophthalmol, 2018. 38(4): p. 522–530. - PMC - PubMed
    1. Halloum W., et al., Glucagon-like peptide-1 (GLP-1) receptor agonists for headache and pain disorders: a systematic review. 2024. 25(1): p. 112. - PMC - PubMed

Publication types

LinkOut - more resources