Reacción a "Use of GLP-1 analogue drugs is associated with benefits but also health risks"

Studies such as these have to be interpreted very cautiously as the people studied have not been randomly allocated to GLP1 receptor agonist treatment, so any difference between those taking and not taking the class of drug could potentially be attributable to factors other than the drug. As the data comes from the UK Veterans Administration it is heavily skewed to older white males.

That said , the study provides useful reassurance about the safety of this class of drugs. The expected benefits on heart disease, stroke and other cardiovascular and most kidney diseases are clearly seen. There is also a reassuring reduction in the incidence of several cancers, including pancreatic. Importantly, as there has been discussion in the media about possible adverse effects of the drugs on mental health, the group taking the drug had a lower incidence of schizophrenia, alcohol and drug use disorders, and less suicidal ideation. In terms of other disorders affecting the brain there was a small but statistically significant reduced risk of seizures and of dementia in those taking GLP1RAs.

In terms of the list of conditions and/ or symptoms that are reported to be increased by GLP1 receptor agonists, as expected gastrointestinal upset of various kinds is most common adverse effect. The small but significant increase in people with low blood pressure and with kidney stones are likely attributable to the fact that a combination of diarrhoea and reduced oral intake can lead some people to become somewhat  fluid-depleted. The most surprising finding is an increase in a range of symptoms relating to joint pain. It is possible that the increased physical activity that is made possible when people lose substantial amounts of weight could result in the appearance of joint  symptoms that were previously masked by inactivity. On the other hand,  the fact that receptors for GLP1 are present on subsets of immune cells means that until we have deeper knowledge, the effects of these drugs on inflammatory responses are somewhat unpredictable. While some inflammatory disorders may be assisted by these drugs others might conceivably be exacerbated. Further research is needed.

Overall the results of this study,  which followed over 200,000 people with diabetes who were treated with GLP1RAs and compared them to over 1.5 million people on other forms of diabetes treatment,  is reassuring regarding the risk/benefit ratio for the long term use of GLP1RAs in people with diabetes. Future studies of people treated with these drugs for obesity, without accompanying diabetes, are awaited with interest.