Ozempic-Like Drugs Could Treat Chronic Migraines, Trial Finds
Originally designed to treat type 2 diabetes, GLP-1 agonists have also shown unforeseen benefits to heart, brain, liver, and kidney health – and now, it seems, the head, alleviating migraines in a new study.
In a pilot trial of 31 patients with high BMI and frequent or chronic migraines, participants who received a daily injection of the GLP-1 agonist liraglutide experienced significantly fewer painful headaches. After 12 weeks, the number of days with a migraine each month decreased from a mean of 19.8 days to just 10.7 days – a reduction of nearly half.
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Weight loss, age, sex, and the use of other medications at the same time did not significantly alter the results.
"Our findings show that liraglutide may be effective in the treatment of unresponsive high-frequency or chronic migraine in patients with obesity, and that this effect is independent from weight loss," conclude the authors, who hail from the University of Naples in Italy.
"This suggests… that the mechanisms driving liraglutide's effectiveness in migraine prevention may operate independently of the significant metabolic effects… "
Further studies with larger cohorts and a control group are needed to verify that hypothesis. But GLP-1 agonists, like liraglutide and possibly even its longer-lasting relative semaglutide, may prove to be a promising route for future migraine treatments.
Migraines impact an estimated 14 to 15 percent of the global population, and yet the few medications we have on hand do not work for everybody.
"A substantial number of patients still face an unmet need, especially when preventive drugs prove ineffective," writes a team of scientists led by neurologist Simone Braca.
Participants in the current pilot trial had migraines unresponsive to other treatments, meaning liraglutide worked where other drugs had not.
GLP-1 agonists slow appetite and help regulate blood sugar by mimicking a natural hormone in the body, called glucagon-like peptide-1, which is released after eating. That's why these drugs are so effective when it comes to managing type 2 diabetes and weight gain.
But GLP-1 receptors exist throughout the body, in many different tissues and organs. The fact that liraglutide and similar medications have widespread effects outside of the pancreas makes logical sense. Still, scientists are trying to figure out what those effects are, and whether they help or harm.
In recent years, studies have shown liraglutide and other GLP-1 agonists can greatly reduce intracranial pressure in the brain – a speculative trigger for migraines.
In animal models, these drugs have also suppressed migraines with great effectiveness.
The current pilot trial is only small and it did not investigate the mechanisms behind liraglutide's migraine relief, nor did it directly measure intracranial pressure among participants.
Nevertheless, Braca and her colleagues suspect that reduced pressure in the skull is playing a role in migraine reduction. In recent animal studies, GLP-1 agonists reduced fluid in the central nervous system, thereby lowering intracranial pressure.
"These findings provide a foundation for larger-scale trials aimed at further investigating the role of GLP-1R agonists in migraine management," Braca and her team conclude.
The study was published in Headache.
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