SUN-031 Efficacy Of The Glp-1 Agonists In The Treatment Of Idiopathic Intracranial Hypertension: A Systematic Review And Meta-analysis

Disclosure: L. Montejano: None. G.G. Carolino: None. A.K. da Silva: None. G.A. Damaceno: None. J.M. Comprido: None. A.S. Carregosa: None. A. Deluca: None. R.C. Maciel: None. C. Melo: None. A. D'lucas: None. M. Molinari: None. L. Filagrana: None. F.P. Risuenho: None. E. Faccin: None. Introduction: Idiopathic intracranial hypertension (IIH), also known as Pseudotumor Cerebri Syndrome (PCS), is characterized by elevation of intracranial pressure. GLP-1 receptor agonists have been hypothesized to reduce cerebrospinal fluid production. Additionally, this medication promotes weight loss in patients with obesity, a known risk factor for PCS. Purpose: We aim to assess the efficacy of GLP-1 agonists in IIH patients. Methodology: We searched Pubmed, Embase, and Cochrane databases for studies that compared GLP-1 agonists to placebo in patients with active IIH. The primary endpoint was refractory IIH. The secondary endpoints were papilledema, intensity and frequency of headache, and visual disturbance or blindness. Risk ratios (RR) and 95% confidence intervals (CI) were pooled using a random-effects model in R version 4.4.3. Heterogeneity was evaluated using the I² statistical. Results: Five studies comprising 1,290 patients with IIH were included, three of them were randomized controlled trials. GLP-1 receptor agonist consistently reduced the risk of refractory at 6 (RR 0,78; 95% CI 0.67 - 0.91; p < 0.001) and 24 months (RR 0.81; 95% CI0.72 - 0.91; p < 0.001). Additionally, GLP-1 receptor agonists reduced papilledema in 3 (RR0.35; 95% CI 0.27 - 0.47; p < 0.001), 6 (RR 0.41; 95% CI 0.32 - 0.52; p < 0.001), 12 (RR0.47; 95% CI 0.38 - 0.58; p < 0.001) and 24 months (RR 0.47; 95% CI 0.38 - 0.58; p < 0.001), headache in 3 months (RR 0.69; 95% CI 0.56 - 0.85; p < 0.001) and blindness in 3 (RR 0.37; 95% CI 0.24 - 0.56; p < 0.001), 6 (RR 0.41; 95% CI 0.23 - 0.70; p <0.001) and 24 months (RR 0.43; 95% CI 0.24 - 0.80; p < 0.007). Conclusion: GLP-1 receptor agonists effectively reduce the risk of refractory IIH and improve IIH symptoms with sustained benefits at 24 months. These findings highlight the potential of GLP-1 receptor agonists as a long-term therapeutic strategy for IIH management. Further studies are warranted to confirm these results and assess their broader clinical implications. Presentation: Sunday, July 13, 2025