GLP-1s: researchers explore new treatment targets

Researchers report that GLP-1 receptor agonists, now widely used for Type 2 diabetes and obesity, are being studied for other conditions including heart failure, chronic liver disease, sleep apnea and substance use disorders, with multiple clinical trials ongoing.

GLP-1 receptor agonists, first developed for diabetes and now widely used for Type 2 diabetes and obesity, are being investigated for a broader set of chronic diseases. Harvard-affiliated clinicians say the drugs affect central cardio‑kidney metabolic pathways and reduce excess adiposity, which may influence related conditions. Recent work and clinical trials are exploring uses from heart failure with preserved ejection fraction to chronic liver disease, obstructive sleep apnea and substance use disorders. Clinicians also note that FDA approval is currently limited to Type 2 diabetes and obesity, and that some patient groups and long-term outcomes remain understudied. Notable details: - Researchers describe GLP-1s as acting on central cardio‑kidney metabolic processes and lowering excess adiposity, which may underlie benefits across several conditions. - A recent study cited by Harvard-affiliated researchers reported a 40 percent relative risk reduction for heart failure with preserved ejection fraction compared with older diabetes medication. - The FDA has approved GLP-1 receptor agonists for Type 2 diabetes and obesity; other uses lack approval and insurers sometimes deny coverage for off-label claims. - More than 15 clinical trials are underway globally testing GLP-1s for substance use disorders, and the Suzuki lab is running trials for opioid and alcohol use disorders. - Clinical trials to date have underrepresented groups such as pregnant people, children, and patients with advanced kidney disease or on dialysis. Summary: Researchers and clinicians say GLP-1 drugs have broadened therapeutic possibilities beyond diabetes and obesity and have prompted more cross‑specialty coordination in care. Ongoing studies and trials are investigating safety, formulations and which conditions and patient groups may benefit, while regulatory approval for additional indications and more inclusive long‑term data will take more time.