Glucagon-like peptide-1 agonist safety and efficacy in a multiple sclerosis cohort

Alexandra Balshi; Grace Leuenberger; John Dempsey; Ursela Baber; Jacob A Sloane

doi:10.1016/j.msard.2024.106229

Glucagon-like peptide-1 agonist safety and efficacy in a multiple sclerosis cohort

Mult Scler Relat Disord. 2024 Dec 13:93:106229. doi: 10.1016/j.msard.2024.106229. Online ahead of print.

Authors

Alexandra Balshi¹, Grace Leuenberger¹, John Dempsey¹, Ursela Baber¹, Jacob A Sloane²

Affiliations

¹ Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Kirstein 215, Boston, MA 02215, USA.
² Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Kirstein 215, Boston, MA 02215, USA. Electronic address: jsloane@bidmc.harvard.edu.

PMID: 39693702
DOI: 10.1016/j.msard.2024.106229

Abstract

Background: While glucagon-like peptide-1 agonist medications (GLP-1s) are on the rise, their safety and efficacy have not been studied in people with MS (PwMS).

Objective: To investigate any adverse effects of GLP-1 medications in the MS population as well as their effectiveness for weight loss and vitamin D augmentation.

Methods: We retrospectively identified PwMS who utilized a GLP-1 medication from 2006 to 2024. Wilcoxon signed rank tests for paired samples were used to compare pre- and post-GLP-1 body mass index (BMI), expanded disability status scale (EDSS), timed 25-foot walk (25FTW), and mean vitamin D values. Additional safety outcomes assessed during GLP-1 treatment were deaths, hospitalizations, clinician-confirmed relapses, and new MRI activity.

Results: Following GLP-1 initiation, PwMS had a decrease in BMI (mean % BMI loss 3.7, p = 0.001) and an increase in vitamin D values (mean increase of 8.1 ng/mL, p = 0.0002), while no change in EDSS or T25FW was seen. There were no hospitalizations or deaths after GLP-1 initiation.

Conclusion: GLP-1 medications are safe and effective in PwMS and can help augment vitamin D levels.

Keywords: Glucagon-like peptide-1 agonist; Multiple sclerosis; Vitamin D; Weight loss.