Obesity medications linked to reduced chance of MS in real world

The use of obesity medications — approved drugs for treating diabetes and promoting weight loss — is associated with a reduced chance of developing multiple sclerosis (MS), according to real-world data from the U.S. Food and Drug Administration (FDA), a study found.

In particular, medicines that activate a receptor called GLP-1, which lowers blood glucose or blood sugar levels, all showed potential protective effects against MS.

“These findings suggest a potential for repurposing these medications for MS,” the researchers wrote.

Their study, “Exploring the association between weight loss-inducing medications and multiple sclerosis: insights from the FDA adverse event reporting system database,” was published in the journal Therapeutic Advances in Neurological Disorders.

Obesity is a well-known driver of chronic inflammation in the body, which can help set the stage for the development of MS, an inflammatory disorder affecting the brain and spinal cord.

Research has shown that obesity in early childhood or adolescence increases the risk of MS. It also worsens outcomes for newly diagnosed patients, and is linked to less favorable responses to disease-modifying therapies.

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Because both conditions share inflammatory components, repurposing medications already approved for obesity may be a potential treatment option for MS, research has suggested. Repurposing drugs can reduce the time and cost of development, especially when a drug’s pharmacological properties and safety profile have already been established.

“Drug repurposing, defined as researching new indications for already approved drugs, is gaining attention as a rapid and cost-efficient strategy for developing new treatments,” the researchers wrote.

With this goal in mind, the trio of researchers — from Missouri, Nebraska, and Texas — collaborated to explore a potential relationship between weight loss-inducing drugs and MS risk. The team used data from the FDA’s side effects database, called the Adverse Event Reporting System, or FAERS, as a source.

FAERS is a publicly available database with information on adverse drug reactions and safety signals. By comparing the number of MS-related adverse events with certain drugs versus with all other drugs in the database, an FAERS analysis can identify whether certain medications may reduce the risk of MS.

Medications for diabetes and weight loss included semaglutide (sold under the brand names Ozempic and Rybelsus for diabetes, and Wegovy for weight loss), dulaglutide (sold as Trulicity), liraglutide (Victoza and Saxenda, among others), empagliflozin (Jardiance, among others), and metformin (Glumetza, among others).

Other weight loss drugs included phentermine (sold as Lomaira, among others), bupropion (Aplenzin, among others), topiramate (Topamax, among others), zonisamide (Zonegran, among others), amphetamine (Azendys, among others), and naltrexone (brand name Relistor, among others).

Analyses revealed that several anti-diabetic weight loss medications were associated with a reduced risk of MS. In particular, semaglutide significantly lowered the likelihood of developing MS by 76.2%, dulaglutide by 83.5%, liraglutide by 83.9%, empagliflozin by 76.6%, and metformin by 61.3%.

Overall, this study hints at the possibility of considering anti-diabetic drugs with weight loss-inducing effects … for potential repurposing opportunities in MS.

The researchers noted that semaglutide, dulaglutide, and liraglutide all work by activating GLP-1, which is believed to ease diabetes and promote weight loss by lowering blood glucose levels.

However, activators of this receptor also are gaining attention due to their ability to protect nerve cells from damage, promote nerve cell growth, and boost the integrity of the blood-brain-barrier, a tight, semi-permeable membrane that controls which substances in the bloodstream can get into the brain.

“The potential efficacy of GLP-1 receptor agonists specifically dulaglutide and liraglutide toward MS has been shown in studies of experimental autoimmune encephalomyelitis (EAE),” a common MS mouse model, the researchers wrote, noting that dulaglutide reduced the severity of MS-like symptoms which and liraglutide delayed their onset.

Among the other obesity medications, no associations were found except for naltrexone, which lowered the likelihood of MS risk by 44.4%.

“Overall, this study hints at the possibility of considering anti-diabetic drugs with weight loss-inducing effects, especially GLP-1 receptor agonists, for potential repurposing opportunities in MS,” the researchers wrote.