{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T20:46:25Z","timestamp":1790628385095,"version":"4.1.0"},"reference-count":27,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2025,9,5]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure and most commonly affects obese women. While its etiology remains unclear, many patients require ventriculoperitoneal shunting (VPS) for symptoms. In those with transverse sinus stenosis, venous sinus stenting (VSS) is an alternative. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been associated with reduced headache burden and visual symptoms in IIH. Since GLP-1 RAs reach steady state around 5\u2009weeks and can produce 10%\u2009weight loss by 6\u2009months, we evaluated their impact on neurosurgical\/neurovascular procedures at these time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Our retrospective cohort study utilized TriNetX Research Network to compare IIH patients treated with GLP-1 RAs to untreated controls. Propensity score matching balanced demographics, comorbidities, and medication use before comparing odds of neurosurgical interventions, including VSS, VPS, and optic nerve sheath fenestration (ONSF) at \n\u2265\n5\u2009weeks and \n\u2265\n6 months after GLP-1 RA initiation. Odds ratios (OR) were estimated via a generalized linear model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After propensity matching, 2690 patients were included in each group. GLP-1 RA use was linked to lower odds of undergoing VSS at 5 weeks (OR 2.40; CI: 1.44 to 4.00; P\n                      <jats:italic>=<\/jats:italic>\n                      0.0005) and 6 months (OR 2.31; CI: 1.10 to 4.86; P\n                      <jats:italic>=<\/jats:italic>\n                      0.0233) and lower odds of VPS at 5\u2009weeks (OR 3.34; CI: 2.00 to 5.61; P\n                      <jats:italic>=<\/jats:italic>\n                      0.0001) and 6 months (OR 2.51; CI: 1.35 to 4.68; P\n                      <jats:italic>=<\/jats:italic>\n                      0.0026).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>GLP-1 RA therapy was associated with lower odds of neurosurgical intervention in IIH patients. These findings support evidence of GLP-1 RAs as a potential noninvasive treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jnis-2025-024139","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T17:20:23Z","timestamp":1758648023000},"page":"1927-1934","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Association between GLP-1 receptor agonist use and neurosurgical intervention in patients with idiopathic intracranial hypertension and obesity: a propensity-matched, multi-institutional, cohort study"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4203-9371","authenticated-orcid":false,"given":"Jaylene Cassandra","family":"Debiec","sequence":"first","affiliation":[{"name":"Department of Neurology, Allegheny Health Network, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Toth","sequence":"additional","affiliation":[{"name":"Drexel University College of Medicine, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3777-5670","authenticated-orcid":false,"given":"Romil","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Neurology, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nihas","family":"Mateti","sequence":"additional","affiliation":[{"name":"Department of Neurology, Allegheny Health Network, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Saim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Allegheny Health Network, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan A","family":"Shakeel","sequence":"additional","affiliation":[{"name":"Department of Neurology, Allegheny Health Network, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Luther","sequence":"additional","affiliation":[{"name":"Allegheny General Hospital, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,9,23]]},"reference":[{"key":"2026081703402602000_18.9.1927.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2017.01.006"},{"key":"2026081703402602000_18.9.1927.2","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1097\/00041327-200103000-00003","article-title":"Epidemiology of idiopathic intracranial hypertension in Israel","volume":"21","author":"Kesler","year":"2001","journal-title":"J Neuroophthalmol"},{"key":"2026081703402602000_18.9.1927.3","doi-asserted-by":"crossref","DOI":"10.1186\/s10194-023-01631-z","article-title":"Treatment with GLP-1 receptor agonists is associated with significant weight loss and favorable headache outcomes in idiopathic intracranial hypertension","volume":"24","author":"Krajnc","year":"2023","journal-title":"J Headache Pain"},{"key":"2026081703402602000_18.9.1927.4","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2023-332222"},{"key":"2026081703402602000_18.9.1927.5","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2024-022174"},{"key":"2026081703402602000_18.9.1927.6","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.c2701","article-title":"Low energy diet and intracranial pressure in women with idiopathic intracranial hypertension: prospective cohort study","volume":"341","author":"Sinclair","year":"2010","journal-title":"BMJ"},{"key":"2026081703402602000_18.9.1927.7","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2017-317440"},{"key":"2026081703402602000_18.9.1927.8","doi-asserted-by":"publisher","DOI":"10.1586\/14737175.2015.1066675"},{"key":"2026081703402602000_18.9.1927.9","unstructured":"TriNetX . TriNetX, LLC. 2025 Available: https:\/\/trinetx.com\/"},{"key":"2026081703402602000_18.9.1927.10","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2025.1516126","article-title":"A comprehensive review of methodologies and application to use the real-world data and analytics platform TriNetX","volume":"16","author":"Ludwig","year":"2025","journal-title":"Front Pharmacol"},{"key":"2026081703402602000_18.9.1927.11","doi-asserted-by":"publisher","DOI":"10.2307\/2344614"},{"key":"2026081703402602000_18.9.1927.12","doi-asserted-by":"crossref","first-page":"12","DOI":"10.11613\/BM.2014.003","article-title":"Understanding logistic regression analysis","volume":"24","author":"Sperandei","year":"2014","journal-title":"Biochem Med"},{"key":"2026081703402602000_18.9.1927.13","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2020.00869","article-title":"Idiopathic Intracranial Hypertension in the United States: Demographic and Socioeconomic Disparities","volume":"11","author":"Ghaffari-Rafi","year":"2020","journal-title":"Front Neurol"},{"key":"2026081703402602000_18.9.1927.14","doi-asserted-by":"publisher","DOI":"10.1097\/WNO.0000000000001107"},{"key":"2026081703402602000_18.9.1927.15","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1097\/WCO.0000000000001209","article-title":"Idiopathic intracranial hypertension: expanding our understanding","volume":"36","author":"Markey","year":"2023","journal-title":"Curr Opin Neurol"},{"key":"2026081703402602000_18.9.1927.16","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000035545","article-title":"Should topiramate be initial therapy in the management of idiopathic intracranial hypertension?: A literature review","volume":"102","author":"Goyal","year":"2023","journal-title":"Medicine (Baltimore)"},{"key":"2026081703402602000_18.9.1927.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2024.122948"},{"key":"2026081703402602000_18.9.1927.18","doi-asserted-by":"crossref","unstructured":"Raygor KP , Jaikumar V , Malueg MD , et al . Comparative Analysis of Dural Venous Sinus Pressures, Gradients, and Dimensions in Idiopathic Intracranial Hypertension Between Stented and Unstented Patients. Neurosurgery 2025. doi:10.1227\/neu.0000000000003498","DOI":"10.1227\/neu.0000000000003498"},{"key":"2026081703402602000_18.9.1927.19","doi-asserted-by":"publisher","DOI":"10.3109\/02688697.2010.544781"},{"key":"2026081703402602000_18.9.1927.20","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-020-01288-1"},{"key":"2026081703402602000_18.9.1927.21","doi-asserted-by":"publisher","DOI":"10.1227\/neu.0000000000002718"},{"key":"2026081703402602000_18.9.1927.22","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2024-022540"},{"key":"2026081703402602000_18.9.1927.23","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1038\/s41433-023-02908-y","article-title":"Effect of glucagon like peptide-1 receptor agonist exenatide, used as an intracranial pressure lowering agent, on cognition in Idiopathic Intracranial Hypertension","volume":"38","author":"Grech","year":"2024","journal-title":"Eye (Lond)"},{"key":"2026081703402602000_18.9.1927.24","doi-asserted-by":"crossref","first-page":"3509","DOI":"10.2147\/DDDT.S506957","article-title":"A Comprehensive Review on the Pharmacokinetics and Drug-Drug Interactions of Approved GLP-1 Receptor Agonists and a Dual GLP-1\/GIP Receptor Agonist","volume":"19","author":"Min","year":"2025","journal-title":"Drug Des Devel Ther"},{"key":"2026081703402602000_18.9.1927.25","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.ajcnut.2025.04.023","article-title":"Nutritional priorities to support GLP-1 therapy for obesity: a joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society","volume":"122","author":"Mozaffarian","year":"2025","journal-title":"Am J Clin Nutr"},{"key":"2026081703402602000_18.9.1927.26","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1001\/jamainternmed.2023.8526","article-title":"Approach to Obesity Treatment in Primary Care: A Review","volume":"184","author":"Yanovski","year":"2024","journal-title":"JAMA Intern Med"},{"key":"2026081703402602000_18.9.1927.27","first-page":"1","article-title":"Impact of GLP-1 receptor agonists on idiopathic intracranial hypertension clinical and neurosurgical outcomes: a propensity-matched multi-institutional cohort study","volume":"2025","author":"O\u2019Leary","year":"2025","journal-title":"J Neurosurg"}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jnis-2025-024139","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:40:49Z","timestamp":1786963249000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/jnis-2025-024139"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,23]]},"references-count":27,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,8,17]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/jnis-2025-024139"],"URL":"https:\/\/doi.org\/10.1136\/jnis-2025-024139","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"value":"1759-8478","type":"print"},{"value":"1759-8486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,23]]}}}