GLP-1 Receptor Agonists: Beyond Diabetes—What the Neurosurgeon Needs to Know

Neurosurgery Practice, 2024 · DOI: 10.1227/neuprac.0000000000000098 · Published: June 27, 2024

Simple Explanation

GLP-1 receptor agonists (GLP-1 RAs) are medications initially used for diabetes but are now gaining popularity for weight management and other benefits. Neurosurgeons need to understand these drugs because increasing numbers of patients are using them, and they have implications for surgical procedures and various neurological conditions. These medications have shown promise in treating substance use disorders, providing neural protection and rehabilitation, and managing neurodegenerative diseases like Alzheimer's. Understanding their perioperative management is crucial for neurosurgeons. GLP-1 RAs may influence the management of conditions treated by neurosurgeons due to their potential clinical and preclinical benefits, making it important for neurosurgeons to stay informed about their use and implications.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
GLP-1 RAs require tailored management for surgical patients, according to recent guidance from the American Society of Anesthesiologists.
2
GLP-1 RAs have demonstrated positive effects concerning substance use disorders, neural protection and rehabilitation, and neurodegenerative disorders, such as Alzheimer’s disease.
3
GLP-1 RAs can impact neurosurgical patients by affecting perioperative management, offering potential benefits in neuroprotection and rehabilitation, and influencing eligibility for neurosurgical interventions.

Research Summary

This article reviews what neurosurgeons need to know about the perioperative management of GLP-1 RAs. It discusses existing literature in clinical and preclinical studies for potential indications and benefits of these medications. GLP-1 RAs play a pivotal role in various medical domains, ranging from glycemic control to cardiovascular health, neuroprotection, and potential applications in neurosurgery. As GLP-1 RAs gain recognition for their potential benefits beyond glycemic control and metabolic regulation, their broader applications warrant a more comprehensive understanding to optimize patient safety and outcomes in the dynamic field of neurosurgery.

Practical Implications

Perioperative Management

Neurosurgeons must be aware of the nuances of GLP-1 RAs and their unique peri-operative risk profile to ensure patient safety during surgical procedures.

Therapeutic Agents

The pharmacological regulation of the GLP-1 metabolic pathway has potentially profound and widespread implications for the management of many neurosurgical conditions, potentially providing new therapeutic agents to augment current interventions.

Clinical Research

Emerging preclinical studies show promising results for using GLP-1 RAs in neural protection and rehabilitation in various pathologies, expanding the potential for clinical research and further investigation for clinical use in neurological conditions.

Study Limitations

1
Current evidence on the use of GLP-1 RAs for the indications discussed in this review remains in its early stages.
2
Further prospective clinical trials are needed to better understand the benefits and risks of using this class of drugs in various disorders affecting neurosurgical patients.
3
Predominantly preclinical studies in the fields of neural rehabilitation and recovery.

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