People with diabetes taking medications found in weight-loss jabs have a reduced risk of 42 conditions, research has found, paving the way for such drugs being used to treat a host of health problems.
The most comprehensive study of its kind showed that psychotic disorders, infections and dementia were among conditions found to be less likely to occur when using GLP-1RAs, which are found in the medications Saxenda, Wegovy and Mounjaro.
The researchers compared health outcomes for people with diabetes who received usual care with those also given drugs such as liraglutide, semaglutide and tirzepatide. While the team revealed the risk of many conditions was lower for the latter group, the risk of other conditions, including arthritic disorders, was increased.
And the scientists say that the benefits are not just restricted to people with diabetes, suggesting they could also be found in other people using the jabs, such as those who take them to fight obesity.
“We only studied people with diabetes but there is no biologic or clinical reason to think that the beneficial and risk profiles would be very different in people without diabetes,” said Prof Ziyad Al-Aly, a co-author of the research from Washington University in St Louis.
However, Aly said it was unlikely people without obesity would experience a similar range of potential benefits, adding that some of the positive associations might be linked to weight loss – while it was also important to consider the risks.
Writing in the journal Nature Medicine, the team report how they analysed records from the US Department of Veterans Affairs databases to explore associations between GLP-1RAs and 175 health outcomes.
The data included 215,970 individuals with diabetes who received these drugs in addition to usual care in the form of other blood-sugar lowering medications, as well as 1,203,097 individuals with diabetes who only received usual care. Participants were tracked for a median of about 3.5 years with the average body mass index above the threshold for obesity.
“We wanted, literally, to map the landscape of benefits and risks,” said Al-Aly.
The results reveal that, compared with usual care, GLP-1RAs were associated with a lower risk of 42 health outcomes, from clotting disorders to chronic kidney disease. More specifically, the risk was reduced by 13% for opioid-use disorders; 19% for bulimia; 18% for schizophrenia and other psychotic disorders; 10% for suicidal ideation, attempt or intentional self-harm; 12% for Alzheimer’s disease; and 12% for bacterial infections.
However the team found GLP-1RAs were associated with a greater risk of 19 conditions compared with usual care, including abdominal pain, nausea and vomiting, low blood pressure and kidney stones.
While some associations were expected, Al-Aly noted others – such as the lower risk of infection – were more puzzling. And while Al-Aly noted weight loss could lead to less arthritis because there was less stress on weight-bearing joints, the new study found that people taking GLP-1RAs had an increased risk of arthritis.
“This is likely related to decreased muscle mass and some deconditioning that happens in people who rapidly lose weight,” Al-Aly said, although he noted this requires further research.
The health associations linked to GLP-1-RAs were also compared with those for hundreds of thousands of individuals receiving other types of anti-diabetic medication. Again, the team found the GLP-1-RA drugs were associated with a reduced risk of many conditions, but an increased risk of others.
“This type of analysis can teach us about mechanisms of diseases that we have not considered previously – and could open pathways to new treatments for these conditions,” said Al-Aly.
It is not the first time GLP-1RAs have been linked to a host of potential health benefits: researchers are already exploring whether they could prove helpful in areas ranging from dementia to cancer.
Prof Naveed Sattar of the University of Glasgow, who was not involved in the study, said randomised trials were needed to explore new associations suggested by the study, but noted trials had already proved many of the potential benefits, such as a reduced risk of heart attacks.
“As more larger trials report, we will learn more about these classes of medicines, especially those that also give big weight loss, allowing us to better understand their net benefits and safety and potential widening their indications,” he said.
