AAN 2026 | Semaglutide and the risk of adult-onset epilepsy in type 2 diabetes

I guess the semaglutide, one of the very common medications as a GLP-1 receptor agonist, which was initially FDA approved for cardiovascular and obesity, but now there is some evidence that is actually growing upon its potential to help control neuroinflammation disease or other indications. So we were interested in how any pharmacological effects of this semaglutide would affect adult-onset seizures. Unfortunately, there is not a really good prospective control study so far, so we analyzed observational data sets using counterfactual clinical trial emulations as a method to look into any protective effects of semaglutide for adult-onset seizures in the type 2 diabetes population. Interestingly, our main finding was that semaglutide has a protective effect on the occurrence of late-onset seizures in adults compared to other glucose-lowering agents or SGLT2 inhibitors. And we used the methodology called IPTW and TMLE, which are also used for better statistical robustness; we validated all those things within some sensitivity analyses, which had consistent findings. The other thing that we did in this study was that we had additional questions about whether there was any mediation by HbA1c or a protective effect for obesity. So we checked upon the HbA1c and BMI in these conclusions, but there was no clear mediation effect with BMI or obesity from the semaglutide used for the outcome of seizures. So I would say this study was summarized as semaglutide may have potential protective effects for adult-onset seizures, but still, this is a counterfactual target trial emulation. So I would say there is more warranted prospective study to prove or consolidate this hypothesis.

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