GLP-1 receptor agonist use is associated with shorter survival in patients with amyotrophic lateral sclerosis and diabetes mellitus
- Design
- Retrospective cohort · 136 participants · Hard outcome
- Match to healthy normal-weight adults aged 55–75
- Different population[Auto] Participants had obesity/overweight (age/BMI not reported in abstract).
- Could weight loss explain it?
- Unknown[Auto] Harm signal; weight-loss mediation not the relevant question, but consider whether harms relate to rapid weight loss or reduced intake.
- Study tier
- Preliminary[Auto] Not peer reviewed (preprint, abstract or registration). Early-warning only.
- Assessment
- Version 1 · automatic, not yet reviewed by a person · Sep 13, 2026
Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75. This item has not been peer reviewed.
[Auto, unreviewed; last sentences of abstract] After adjusting for covariates, the GLP-1RA group was associated with increased mortality compared to the No-GLP-1RA group (hazard ratio 2.5, 95% confidence interval [1.1, 5.3], p=0.02). ConclusionsTreatment with GLP-1RA is associated with shorter tracheostomy-free survival in people with ALS and comorbid DM.
01Findings
What the study reported
- Drugs
- Class unspecified
- Comparator
- 66 years old
- Primary outcome
- Not extracted
- Effect
- Not extracted
- 95% confidence interval
- Not extracted
- Follow-up
- 66 years
- Adverse events
- Not extracted
- Limitations
- Auto-classified from abstract only; effect estimates, adverse events and limitations not extracted. Requires manual review.
Who was studied
- Obesity status
- obesity/overweight present (all or most)
- Diabetes status
- diabetes mentioned
- Sample size
- 136
Study quality details
- Study design
- Retrospective cohort
- Sample size
- 136
- Randomization
- no
- Blinding
- not stated
- Comparator
- not stated
- Follow up duration
- 66 years
- Outcome type
- hard
- Replication
- not assessed (auto)
- Consistency with other evidence
- not assessed (auto)
- Population applicability
- INDIRECT
- Statistical precision
- CI reported: 95% confidence interval [1
- Risk of bias
- not assessed (auto)
- Funding conflicts
- unclear
- Peer review status
- no
02Funding
Funding and conflicts
- Funding
- not reported in abstract
- Industry funded
- Unclear
- Manufacturer
- None identified
- Sponsor role
- not reported in abstract
- Author conflicts
- not available in metadata
- Independent replication
- unknown
Funding is shown on every study and never used to score it.
04Source
The source, as retrieved
Abstract
BackgroundThe glucagon-like-peptide-1 (GLP-1) hormone exerts metabolic effects leading to delayed gastric emptying, decreased appetite, and lower blood glucose levels. GLP-1 receptor agonists (GLP-1RA) are increasingly used to treat diabetes mellitus (DM) and obesity. However, their impact on the progression of amyotrophic lateral sclerosis (ALS) is unknown. ObjectiveWe examined the relationship between GLP-1RA treatment and disease progression among people with ALS and DM. MethodsAn electronic health record search was conducted to identify consecutive patients seen at a single institution from 2020 to 2024 with ALS and DM diagnostic codes. All charts were reviewed for demographics, disease history, medication use, and tracheostomy/survival. Patients who did not meet Awaji ALS diagnostic criteria, lacked a documented history of DM, or had insufficient records were excluded. Patients were grouped by GLP-1RA exposure. Tracheostomy-free survival was compared between the GLP-1RA and No-GLP-1RA groups using Kaplan-Meier survival curves, log-rank test and Cox-proportional hazard models adjusted for age, sex, bulbar onset, body mass index (BMI) at diagnosis, and riluzole use. ResultsTotal 1,310 ALS patients were screened, 136 patients (10%) had comorbid DM. After chart review, 85 patients meeting inclusion and exclusion criteria were included, 15 (18%) of whom were treated with GLP-1RA. Compared to No-GLP-1RA group, GLP-1RA group was younger at symptom onset (59 vs 66 years old, p<0.01), had shorter diagnostic delay (12 months vs 17 months, p=0.04) and higher weight at diagnosis (85kg vs 73kg, p=0.02). Tracheostomy-free survival from symptom onset trended shorter in the GLP-1RA group (median survival 28.7 vs 34.9 months, p=0.08). After adjusting for covariates, the GLP-1RA group was associated with increased mortality compared to the No-GLP-1RA group (hazard ratio 2.5, 95% confidence interval [1.1, 5.3], p=0.02). ConclusionsTreatment with GLP-1RA is associated with shorter tracheostomy-free survival in people with ALS and comorbid DM.
Where this record came from
| Source | Retrieved | Identifier |
|---|---|---|
| medrxiv:medrxiv | Sep 13, 2026 | 10.1101/2025.05.05.25326993 first ingestion |