Summary: A new study finds that semaglutide, known as Ozempic/Wegovy, has no negative impact on brain health and may reduce cognitive problems and nicotine addiction. The analysis, based on more than 100 million patient records, found no increased risk of neurological or psychiatric disorders compared to other diabetes drugs.
These results suggest that the benefits of semaglutide may extend beyond diabetes management. Further research is needed to confirm these potential benefits.
Highlights:
- No negative impact: Semaglutide does not increase the risk of neurological or psychiatric disorders.
- Potential benefits: Associated with lower risk of cognitive problems and nicotine dependence.
- Detailed data: The analysis covered more than 100 million patient records, including 20,000 on semaglutide.
Source: University of Oxford
Semaglutide, better known as Ozempic/Wegovy, has no negative impact on brain health and is associated with a lower risk of cognitive problems and less nicotine dependence, a new study finds.
The analysis, led by researchers at the University of Oxford and supported by the National Institute for Health Research (NIHR), the Oxford Health Biomedical Research Centre and the Medical Research Council, found that taking the drug, a popular medication for type 2 diabetes, carried no increased risk of adverse neurological or psychiatric effects compared with other diabetes drugs, challenging recent concerns about the drug’s safety.
The full analysis, published in the journal Electronic clinical medicine, The study used more than 100 million patient records in the United States, including more than 20,000 who were taking semaglutide. It found that semaglutide:
- Has not been associated with an increased risk of neurological and psychiatric disorders, such as dementia, depression or anxiety, compared with other common antidiabetic drugs
- Was associated with a lower risk of cognitive problems and nicotine dependence.
“Our results suggest that the use of semaglutide could extend beyond diabetes management, potentially offering unexpected benefits in the treatment and prevention of cognitive decline and substance misuse,” said Dr Riccardo De Giorgi, clinical lecturer at the University of Oxford and lead author of the study.
“The results of our study therefore not only help to reassure the millions of patients who rely on semaglutide for the management of diabetes, but, if confirmed, could also have important public health implications in terms of reducing cognitive impairment and smoking rates in patients with diabetes.”
Although the study’s robust methodology and comprehensive data provide strong evidence, the researchers say more research is needed and it is not yet clear how semaglutide may have these effects.
“Our study is observational and these results should therefore be replicated in a randomized controlled trial to confirm and extend our findings,” said Dr Max Taquet, clinical lecturer at the University of Oxford and lead author of the study.
“This is nevertheless good news for patients with psychiatric disorders, who are at increased risk of diabetes.”
Dr. De Giorgi adds that although semaglutide is also used in obese people, as some diabetic patients also have higher weight, the results of this study cannot be applied to people who do not have diabetes.
About this news on neuropharmacology research
Author: Richard De George
Source: University of Oxford
Contact: Riccardo De Giorgi – University of Oxford
Picture: Image credited to Neuroscience News
Original research: Free access.
“12-month neurological and psychiatric outcomes of semaglutide use for type 2 diabetes: a propensity score-matched cohort study” by Riccardo De Giorgi et al. Electronic clinical medicine
Abstract
Neurological and psychiatric outcomes at 12 months of semaglutide use for type 2 diabetes: a propensity score-matched cohort study
Background
While semaglutide, approved for type 2 diabetes (T2D), is being studied as a treatment for brain disorders, concerns about adverse neuropsychiatric effects have emerged. Further data are therefore needed to assess the effects of semaglutide on brain health. This study provides reliable estimates of the risk of neurological and psychiatric effects following the use of semaglutide compared with three other antidiabetic drugs.
Methods
This retrospective cohort study used electronic medical records from the TriNetX collaborative network, covering more than 100 million patients in the United States. Due to the exploratory nature of this study, we did not use a pre-registered protocol or statistical analysis plan.
Three cohorts with type 2 diabetes prescribed semaglutide between December 1, 2017, and May 31, 2021, were propensity score matched (1:1 using a greedy nearest neighbor algorithm with a caliper distance of 0.1) with cohorts receiving sitagliptin, empagliflozin, and glipizide.
Using Cox regression analysis, we compared the risks of 22 neurological and psychiatric events within 1 year of the index prescription: encephalitis, parkinsonism, cognitive impairment, dementia, epilepsy/seizures, migraine, insomnia, nervous disorder, myoneural/muscular junction disease, intracranial hemorrhage, ischemic stroke, alcohol abuse, opioid abuse, cannabis abuse, stimulant abuse, nicotine abuse, psychosis, bipolar disorder, depression, anxiety, obsessive-compulsive disorder, and suicidality. Negative control outcomes (NCOs) were used to assess unmeasured confounders.
Results
Each matched cohort included 23,386 (semaglutide against sitagliptin), 22,584 (against empagliflozin) and 19,206 (against Semaglutide was not associated with an increased risk of neurological and psychiatric effects.
Instead, after adjusting for multiple testing, semaglutide was associated with a reduced risk for several of these outcomes, including cognitive impairment compared with sitagliptin (HR 0.72, 95% CI 0.64-0.80) and glipizide (HR 0.72, 95% CI 0.63-0.81), dementia compared with sitagliptin (HR 0.52, 95% CI 0.40-0.68), and nicotine abuse in most comparisons (HR 0.72, 95% CI 0.61-0.85 compared with glipizide; HR 0.77, 95% CI 0.65-0.90 compared with empagliflozin; HR 0.82, 95% CI 0.70-0.95 compared with sitagliptin, although the latter was no longer statistically significant after adjustment for multiple comparisons).
Empagliflozin showed the least differences compared to semaglutide. No differences in NCO were observed between cohorts.
Interpretation
Semaglutide is not associated with a higher risk of adverse neuropsychiatric outcomes over 12 months compared with other antidiabetic drugs. Potential beneficial associations with some outcomes, particularly cognitive impairment and nicotine abuse, should stimulate validation in clinical trials.
Funding
National Institute for Health Research (NIHR) Oxford Health Biomedical Research Centre, Medical Research Council.