Researchers repurpose diabetes drug for brain pressure

Research led by the University of Birmingham indicates that a GLP-1 agonist drug, currently used to lower blood sugar in people with type II diabetes, could be repurposed to treat raised brain pressure.

The condition commonly develops in emergency situations such as traumatic brain injury, hydrocephalus and stroke, but also plays a key role in Idiopathic Intracranial Hypertension (IIH), which can cause daily headaches, severely raised pressure around the nerves in the eye, and permanent vision loss.

The researchers looked at whether GLP-1 agonist drugs could reduce intracranial pressure in an animal model, and found that the GLP-1 agonist exendin-4 was able to do so "both rapidly and dramatically".

"Our findings show that exendin-4 reduces brain pressure within 10 minutes of dosing and by 44 percent, which is a greater extent than anything else we’ve tested before, and the treatment effects last at least 24 hours," said corresponding author Dr Alexandra Sinclair, of the University of Birmingham’s Institute of Metabolism and Systems Research.

Obesity is the major causative risk factor for IIH and, given that GLP-1 agonists cause weight loss in both diabetic and non-diabetic patients, the new approach provides both a direct treatment for raised brain pressure and also a disease modifying approach through driving weight loss in IIH, the researchers note.

Currently, there are no bespoke treatments for IIH.

"GLP-1 agonists are safe and widely used drugs for the treatment of diabetes which means that these findings are rapidly translatable into a novel treatment strategy for IIH. They are also potentially game-changing for other conditions featuring raised brain pressure including stroke and brain trauma," Dr Sinclair added.

The Birmingham team plans to move its research "forward rapidly" into clinical trials.