GLP-1 Agonists

GLP-1 Agonist and Reduction of Cancer:

While some people use GLP-1 agonists to attain weight loss, this may not be the only beneficial side effect of this group of drugs.
People with obesity are more likely to develop cancer, though the mechanisms that underpin this risk are myriad, and subject to intense debate. This may partly be because people with obesity have more cells in their bodies that can become cancerous. Weight loss has been shown to reduce the overall risk of cancer. Another reason why people with obesity might be more likely to develop cancer is due to the impact it can have on a type of immune cells known as natural killer cells. These cells are crucial for detecting and destroying tumor cells. Evidence has existed since 2010 showing that obesity disrupts the ability of natural killer cells to do this, therefore increasing the risk of cancers developing.

Determining the impact of GLP-1 drugs on cancer risk is complex due to multiple factors. These include patient heterogeneity, the role of concomitant medications, variations in the duration and dosage of GLP-1 drugs, and the presence of other risk factors like genetics and lifestyle factors. Also, cancer is a disease that develops over a long period, making it challenging to establish a direct cause-effect relationship in clinical studies.
The FDA currently includes a warning on the drug that it has been linked to medullary thyroid cancer and can not be used in people with a family history of this cancer.

GLP-1 Agonist and Reduction of Cardiovascular Disease:

In May 2023, a study was published in the Annals of Internal Medicine that showed that the risk of heart failure and hospital admission for major cardiac events, such as heart attack and stroke, was lower in individuals who had received GLP-1 drugs, compared to other glucose-lowering medications.
GLP-1 agonists help with weight loss, which improves a patient’s cardiometabolic status. Glycemic control is essential to benefit cardiovascular health. GLP-1 agonists slightly reduce blood pressure and slightly improve cholesterol levels. These agents are most useful in patients with established atherosclerotic cardiovascular disease. They are thought to possibly have anti-inflammatory effects that may lead to more stabilized atherosclerotic plaques.

GLP-1 Agonist and Reduction of Alzheimer’s and Chronic Inflammation:

Both obesity and type 2 diabetes are linked to developing Alzheimer’s disease — obesity more strongly. One 2020 study of a cohort of over 6,500 individuals in England showed that obesity and a higher waist measurement were both linked to a higher rate of Alzheimer’s disease.
The link between type 2 diabetes, drugs to treat it, and Alzheimer’s risk is more complex, in part because tightly controlled blood sugar actually increases the risk of cognitive impairment, thought to be due to low levels of sugar reaching a part of the brain called the hippocampus.
However, recently, some evidence has emerged suggesting GLP-1 treatment can help to reduce the accumulation of amyloid protein in the hippocampus, the presence of which is believed to contribute to the development of Alzheimer’s disease symptoms.

This study did not investigate the possibility that GLP-1 treatment reduces the risk of developing Alzheimer’s disease due to other actions, such as the reduction in inflammation, which is also thought to contribute to Alzheimer’s disease development.

Further research is needed to expand the understanding of which patient groups beyond the existing ones can benefit from the use of GLP-1 medications. Specifically, there is a need to investigate the long-term effects of these medications in non-diabetic individuals, as the existing data primarily focuses on diabetic patients.