{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:34:43Z","timestamp":1788406483786,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Managing obesity in patients with epilepsy is complicated by the weight\u2010gaining properties of essential antiseizure medications (ASMs) such as valproate and pregabalin. We evaluated the safety and efficacy of initiating glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101 RAs) in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study using the NIH\n                      <jats:italic>All of Us<\/jats:italic>\n                      Research Program database, identifying adults with comorbid epilepsy, type 2 diabetes, and obesity. New initiators of GLP\u20101 RAs were compared with matched controls using 1:1 propensity score matching that included baseline weight\u2010gaining ASM use. The primary safety outcome was a composite of seizure\u2010related hospitalization or new ASM addition. Secondary efficacy endpoints (weight and HbA1c change at 12\u2009months) were stratified by concomitant weight\u2010gaining ASM use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The propensity\u2010matched cohort included 610 patients with well\u2010balanced baseline characteristics. GLP\u20101 RA initiation was not associated with failure to control seizure compared with standard care (hazard ratio 0.92, 95% CI 0.68\u20131.23;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.57); given the observed events, the study could detect a hazard ratio of 1.53 or greater. GLP\u20101 RA users achieved a mean adjusted weight loss of \u22125.73% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and an HbA1c reduction of \u22120.71% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018). Significant weight reduction was achieved even among patients concomitantly treated with weight\u2010gaining ASMs (adjusted difference \u22124.15%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>GLP\u20101 RAs showed no evidence of seizure worsening and remained effective for weight loss even among patients receiving weight\u2010gaining ASMs, supporting their use for metabolic benefit in patients with epilepsy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70505","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T04:51:29Z","timestamp":1786078289000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Safety and Efficacy of\n                    <scp>GLP<\/scp>\n                    \u20101 Receptor Agonists in Adults With Epilepsy, Obesity, and Type 2 Diabetes"],"prefix":"10.1002","author":[{"given":"Hyoshin","family":"Son","sequence":"first","affiliation":[{"name":"Department of Neurology Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4953-759X","authenticated-orcid":false,"given":"Inyoung","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics Hanyang University Seoul Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Won","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics Hanyang University Seoul Hospital  Seoul Republic of Korea"},{"name":"Department of Pharmacology Hanyang University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Kim","sequence":"additional","affiliation":[{"name":"College of Pharmacy Daegu Catholic University  Gyeongsan Republic of Korea"},{"name":"Convergence Research Institute for Biomedical Sciences Daegu Catholic University  Gyeongsan South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468\u20102667(24)00302\u20105"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/wco.0000000000001144"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(15)00225\u20102"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2020.107043"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2008.10.013"},{"issue":"43","key":"e_1_2_10_7_1","first-page":"849","article-title":"Comorbidity in Adults With Epilepsy\u2014United States, 2010","volume":"62","author":"Kadima N. 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