July 2, 2025
Source: drugdu
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In the long journey of the medical field, there are always some drugs that are as dazzling as stars.
Metformin, this name is mentioned repeatedly in the medical field. It has not only been in the field of diabetes treatment for decades, but also shines with multiple potential values such as cardiovascular protection and anti-aging. It can be called a model of "miracle drug".
Today, new hope is emerging. GLP-1 weight loss drugs are emerging, following the trajectory of metformin and exuding unique charm.
Recently, a report in Nature magazine caused a stir. A clinical trial focused on the GLP-1 weight loss drug liraglutide and found that it had unexpected therapeutic potential for migraine.
When GLP-1 attacks migraine
This study on migraine, published in Nature, was led by Lanfranco Pellesi's team at the University of Southampton in Denmark. A total of 38 patients participated, and 31 patients were finally included in the analysis, of which 83.9% were women.
These patients were all chronic migraine patients with obesity and had previously tried at least two preventive medications but failed.
During the 12-week treatment period, patients received once-daily injections of liraglutide.
The results showed that after treatment, the average number of headache days per month in patients decreased significantly from 19.8 days at baseline to 10.7 days, a mean reduction of 9.1 days, which was a statistically significant difference.
Specifically, 48% of patients (15 people) experienced a reduction of more than 50% in their monthly headache frequency, 7 of them experienced a reduction of 75% or more in their headache frequency, and 1 patient's headache symptoms completely disappeared.
Image source: headachejournal.onlinelibrary
What is even more surprising is that during the observation period, the patient's body mass index only dropped slightly from 34.0±2.3kg/m² to 33.9±2.3kg/m². This slight weight change did not reach statistical significance, which means that the drug's effect on improving migraine may be independent of the weight loss effect.
The researchers speculate that a slight increase in intracranial pressure may be one of the causes of migraine attacks, and GLP-1 receptor agonists, which reduce cerebrospinal fluid secretion, have been shown to be effective in treating idiopathic intracranial hypertension. They hypothesized that liraglutide may exert its therapeutic effect by reducing intracranial pressure and inhibiting the cortical and trigeminal sensitization that causes migraine.
Although the study has limitations, such as failure to measure intracranial pressure, fasting blood glucose levels or hemoglobin A1c, lack of randomization and placebo control, and the study population was limited to obese and refractory migraine patients, this finding undoubtedly opens up a new research direction in the field of migraine treatment.
Billion-dollar market
Migraine is a common chronic neurovascular disease with over 1 billion patients worldwide. Its recurrent attacks have a serious impact on patients' quality of life and also bring a heavy economic burden.
Data shows that the global migraine market will be worth $9.6 billion in 2022 and is expected to grow to $17.5 billion by 2027, with a compound annual growth rate of 9.4%. This growth trend is mainly due to the development and application of new drugs, especially drugs targeting calcitonin gene-related peptide (CGRP).
Image source: Xiaoyaoshuoyao
CGRP plays a key role in the pathogenesis of migraine and therefore becomes an important target for drug development.
At present, many CGRP receptor antagonists have been approved worldwide, including monoclonal antibodies and small molecule antagonists. Among them, small molecule antagonists are mainly used for the treatment of acute migraine, while monoclonal antibodies are mainly used for the prevention of chronic migraine. In 2021, Eli Lilly's Galcanezumab became the best-selling CGRP drug with sales of US$577 million, followed by Allergan's Ubrogepant with sales of US$552 million.
At the same time, the increased use of CGRP antagonists will also drive the development of the field of migraine prevention. It is estimated that by 2027, the preventive migraine market will be worth US$10.1 billion, with a compound annual growth rate of 11.3%.
The acute migraine market is mainly driven by the increased clinical application of drugs such as Nurtec, Ubrelvy and Zavzpret, and is expected to grow at a compound annual growth rate of 7.2%.
In addition to CGRP-targeted drugs, triptans, as traditional migraine treatment drugs, still occupy an important position in the market. These drugs effectively relieve migraine symptoms by increasing serotonin levels in the brain, reducing inflammation and constricting blood vessels.
Exploring potential in multiple fields
GLP-1 receptor agonists are a class of drugs with multiple effects that were originally used to treat type 2 diabetes.
In terms of blood sugar control, it lowers blood sugar levels by stimulating insulin secretion, inhibiting glucagon secretion, and delaying gastric emptying. Dulaglutide, semaglutide, etc. are widely used in clinical practice.
As research deepens, the cardiovascular benefits of this type of drugs have gradually been discovered. For example, liraglutide was approved by the FDA in August 2017 for reducing cardiovascular risk in patients with type 2 diabetes. Semaglutide and dulaglutide were also approved for similar indications in January and February 2020, respectively.
In January 2025, semaglutide entered the field of comprehensive management of diabetic nephropathy for the first time and was approved to reduce the risk of renal function deterioration, end-stage renal disease and cardiovascular death in patients with type 2 diabetes and chronic kidney disease, further expanding its role in the prevention and treatment of diabetic complications.
In addition to its wide application in the field of diabetes, GLP-1 receptor agonists also show significant advantages in weight management. Drugs such as liraglutide, semaglutide, and telpotide have been approved for the treatment of obesity, which helps patients lose weight by reducing food intake and appetite, providing new treatment options for obese patients.
In other disease areas, research on GLP-1 receptor agonists is also expanding.
Although it is not currently approved by the FDA for the treatment of type 1 diabetes, studies have shown that it has some potential in lowering HbA1c and reducing weight, and some medical providers use it off-label depending on the patient's condition.
In the treatment of Alzheimer's disease, drugs such as semaglutide are undergoing clinical trials for relevant indications, which is expected to bring new hope to this difficult disease.
In addition, lixisenatide and liraglutide have entered Phase II clinical trials for the treatment of Parkinson's disease, providing potential new treatments for Parkinson's disease patients.
Some GLP-1 drugs have also completed Phase III clinical trials for the indication of heart failure with preserved ejection fraction, such as semaglutide, which may bring new treatment options for patients with heart failure.
Conclusion
The discovery and application of GLP-1 receptor agonists have brought new hope for the treatment of many disease areas. From blood sugar control and cardiovascular protection in type 2 diabetes to weight management, obesity treatment and migraine prevention and treatment, the potential it has shown is remarkable.
As research continues to deepen, GLP-1 receptor agonists will play a key role in the treatment of more diseases and contribute to human health and well-being.
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