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Adjunctive Dulaglutide in Relapsing-Remitting Multiple Sclerosis: A Randomized Open-Label Proof-of-Concept Trial.

Pavel Šiarnik1, Žofia Rádiková2, Branislav Kollár3

  • 11st Department of Neurology, Faculty of Medicine, Comenius University, Mickiewiczova 13, 813 69, Bratislava, Slovakia. palo.siarnik@gmail.com.

Neurology and Therapy
|June 19, 2026
PubMed
Summary
This summary is machine-generated.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) improved metabolic health and showed potential functional benefits in multiple sclerosis (MS) patients. However, this study did not find significant effects on neurodegeneration biomarkers.

Keywords:
DulaglutideGlucagon-like peptide 1 receptor agonistInsulin sensitivityMagnetic resonance imaging volumetryMultiple sclerosisNeurodegenerationNeurofilament light chain

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Area of Science:

  • Neuroscience
  • Endocrinology
  • Immunology

Background:

  • Multiple sclerosis (MS) is a CNS disease causing demyelination and disability.
  • Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are explored for neuroprotective effects in MS.
  • This study investigates GLP-1RA effects on metabolic parameters, function, and neurodegeneration in relapsing-remitting MS (RRMS).

Purpose of the Study:

  • To evaluate the efficacy of adjunctive GLP-1RA (dulaglutide) in RRMS patients.
  • To assess impacts on metabolic parameters, functional performance, and neurodegeneration biomarkers.
  • To explore potential neuroprotective properties of GLP-1RAs in MS.

Main Methods:

  • A prospective, randomized, open-label, proof-of-concept study involving 28 RRMS patients on natalizumab.
  • Patients received either dulaglutide (0.75 mg/week) or no adjunctive therapy for 12 months.
  • Primary outcomes: plasma neurofilament light chain (NfL) and brain MRI volumetry; Secondary outcomes: metabolic, functional, and cognitive measures.

Main Results:

  • Dulaglutide significantly improved weight, BMI, body fat, and glucose tolerance.
  • Exploratory analyses showed trends toward improved walking speed and hand dexterity.
  • No significant differences were observed in plasma NfL, brain MRI measures, or cognitive performance between groups.

Conclusions:

  • Adjunctive dulaglutide improved metabolic parameters and showed exploratory functional benefits in RRMS patients.
  • Dulaglutide did not significantly alter neurodegeneration biomarkers (NfL, MRI volumetry) in this cohort.
  • Larger, powered studies with higher GLP-1RA doses and longer follow-up are needed.