GLP-1RA linked to reduced seizure recurrence risk in diabetic adults with epilepsy

In adult patients with diabetes and epilepsy, treatment with glucagon-like peptide-1 receptor agonists (GLP-1RAs) is associated with lower risks of seizure recurrence, hospitalization, and mortality compared with other glucose-lowering therapies, according to a retrospective study.

Researchers used data from the TriNetX Research Network and looked at adults with ≥3 epilepsy or recurrent seizure diagnoses. They performed propensity score matching to establish paired cohorts of patients initiating a GLP-1RA (exenatide, liraglutide, dulaglutide, lixisenatide, semaglutide, or tirzepatide) without prior comparator therapy and those initiating other glucose-lowering agents (sodium–glucose cotransporter 2 inhibitors, dipeptidyl peptidase 4 inhibitors, sulfonylureas, or insulin) without GLP-1 RA exposure (comparator).

The analysis included 8,688 patients in the GLP-1RA group and 8,688 in the other glucose-lowering agent group (comparator). The mean age of the overall population was 52.6 years, and 67.6 percent were female. The median follow-up was 514 days in the GLP-1RA group and 415 days in the comparator group.

Compared with the comparator group, the GLP-1RA group had 18-percent lower risk of seizure recurrence (hazard ratio [HR], 0.82, 95 percent confidence interval [CI], 0.78–0.86), 65-percent decreased risk of hospitalization (HR, 0.35, 95 percent CI, 0.29–0.43), and 60-percent reduced risk of all-cause mortality (HR, 0.40, 95 percent CI, 0.34–0.47).

Less pronounced associations were observed between GLP-1RA initiation and status epilepticus (HR, 0.75, 95 percent CI, 0.66–0.85) and ICU admission (HR, 0.82, 95 percent CI, 0.69–0.96).

Prospective studies are needed to confirm these findings before translation into clinical practice.