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Evaluating the clinical effects of GLP-1 receptor agonists for Alzheimer's and Parkinson's diseases using minimal clinically important difference: systematic review and meta-analysis
Clinical benefits of GLP-1 receptor drugs for Alzheimer's and Parkinson's diseases measured by meaningful improvement
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Abstract
Fourteen randomized controlled trials involving 1260 participants assessed the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on cognition and clinical outcomes in non-diabetic individuals with Alzheimer's disease, Parkinson's disease, and mild cognitive impairment.
- GLP-1RAs showed a small statistically significant improvement in global cognition, indicated by a standardized mean difference of 0.14.
- Despite this statistical significance, there is only a trivial probability (1%) of a clinically important cognitive benefit.
- In contrast, GLP-1RAs were associated with poorer verbal fluency, with a standardized mean difference of -0.43.
- Pooled estimates for clinical severity, function, depression, and Parkinson's disease-related outcomes generally favored GLP-1RAs, but none reached statistical significance.
- In the Parkinson's disease subgroup, GLP-1RAs significantly improved depression symptoms compared to control, but the improvement was below the clinically important benefit threshold.
- GLP-1RAs significantly reduced weight but were linked to poorer tolerability and increased gastrointestinal adverse events.
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