Efficacy and Safety of Incretin Mimetics in Idiopathic Intracranial Hypertension: A Systematic Review and Meta-Analysis

Abstract

Idiopathic intracranial hypertension (IIH) is a debilitating neurological disorder characterized by increased intracranial pressure (ICP) without an identifiable underlying cause. Incretin mimetics (IMs) have emerged as a promising therapeutic option for IIH. This systematic review and meta-analysis assessed the efficacy and safety of IMs in treating patients with IIH. A systematic review of the literature from PubMed, Embase, Web of Science, and Cochrane databases was conducted, focusing on body mass index (BMI) changes, headache, ophthalmological outcomes, and adverse effects (AEs). Out of 125 articles identified, 3 were included in the analysis. The statistical analysis was performed using Review Manager 5.4.1. This study analyzed 440 patients (23 men, 417 women; mean age 36.92 ± 0.71 years), with 213 (48.4%) receiving IM and a mean follow-up of 21.69 ± 6.2 months. At the 3-month follow-up, no statistically significant difference was found between the IM and control groups (RR: -0.51; 95% CI: [-1.38–0.35]; p = 0.24; I2 = 69%). At the 6-month follow up, the IM group showed statistically significant superiority over the control group (RR: -1.03; 95% CI: [-1.29–-0.77]; p < 0.00001; I2 = 0%). Positive outcomes in headache and ophthalmological parameters were observed at both follow-ups. No serious AEs were reported. Our study suggests that IMs show promising short-term efficacy and safety in treating IIH, positioning them as a potential therapeutic option. However, these findings should be interpreted with caution due to study limitations.