The effect of GLP-1 agonist on idiopathic intracranial hypertension: a systematic review and meta-analysis

Idiopathic intracranial hypertension (IIH) is a condition with elevated intracranial pressure, leading to headaches and vision issues. Current treatments offer limited relief. Glucagon-like peptide-1 (GLP-1) agonists, known for their established metabolic benefits including weight loss and an emerging potential to lower intracranial pressure, may provide a novel approach for managing IIH.

This systematic review and meta-analysis aimed to assess the effectiveness of GLP-1 agonists in improving IIH symptoms.

A systematic review and meta-analysis.

A systematic search of PubMed, Scopus, Web of Science, and Cochrane was conducted until March 2025. Dichotomous outcomes were pooled using risk ratio (RR), while continuous outcomes were pooled using standardized mean difference. PROSPERO ID: CRD420251008614.

The meta-analysis of four studies assessed the efficacy of GLP-1 agonists across various outcomes. Results showed a significant reduction in Body Mass Index (BMI) over 24 months, with mean differences of -0.36, -1.08, -1.18, and -1.42 at 3, 6, 12, and 24 months, respectively, with 95% CI, and low heterogeneity (I² = 0.0%). GLP-1 agonists also reduced headache risk, with the most significant effect at 3 months (RR: 0.69), remaining statistically significant at 6, 12, and 24 months. The risk of papilledema was reduced across all time points, with the lowest RR at 3 months (RR: 0.69 (95% CI: 0.55, 0.86)), and the effect remained significant through 24 months. Additionally, GLP-1 agonists consistently reduced the risk of visual disturbances and refractory IIH, with statistically significant effects sustained up to 24 months, demonstrating a sustained benefit throughout the treatment period.

This meta-analysis demonstrates that GLP-1 receptor agonists are a promising therapeutic option for patients with IIH, demonstrating significant efficacy in reducing intracranial pressure-related symptoms such as BMI, headache frequency, papilledema, and visual disturbances.