Risk of Allodynia with GLP-1 Agonists
GLP-1 receptor agonists may be associated with a higher risk of allodynia compared to bupropion-naltrexone, with an adjusted hazard ratio of 2.15.
Where it sits
this study against the rest of the liraglutide corpusSummary and findings
This study investigated the incidence of allodynia among users of GLP-1 receptor agonists, specifically liraglutide and semaglutide, compared to bupropion-naltrexone. The study included 20,504 adults aged 18 and older who initiated treatment between 2006 and 2020. The results indicated a higher incidence of allodynia in the GLP-1 group.
Abstract
Background Glucagon-like peptide-1 (GLP-1) receptor agonists, including liraglutide and semaglutide, are widely prescribed to treat type 2 diabetes mellitus and obesity. Recent anecdotal reports have suggested these agents might be associated with allodynia, a neuropathic pain syndrome, but large-scale epidemiologic evidence is lacking. Methods To investigate this potential link, a retrospective cohort study was conducted using the IQVIA PharMetrics® Plus database. Adults aged 18 and older who initiated liraglutide, semaglutide, or bupropion-naltrexone between 2006 and 2020 were included, excluding those with prior diabetes or antihyperglycemic therapy. Incident allodynia was identified via ICD-9/10 codes as the primary outcome. Results Among 20,504 new users, those on GLP-1 receptor agonists had an allodynia incidence of 35 per 1,000 person-years, compared to 15 per 1,000 person-years for bupropion-naltrexone users. Adjusted analyses demonstrated over a twofold increased risk of allodynia with GLP-1 receptor agonists (aHR 2.15, 95% CI 1.57–2.96). Conclusion These findings emphasize the need for heightened clinical vigilance and further research into mechanisms and management.