Liraglutide may reduce recurrent stroke risk in people with type 2 diabetes

medwireNews: Liraglutide may reduce the risk for recurrent stroke versus placebo in people with type 2 diabetes who have had a minor acute ischemic stroke (AIS) or a high-risk transient ischemic attack (TIA), study findings indicate.

“To our knowledge, this is the first phase 3 randomized clinical trial to evaluate the efficacy and safety of liraglutide in patients with minor AIS or high-risk TIA and provide preliminary evidence that supports its potential role in secondary stroke prevention,” write Anding Xu (First Affiliated Hospital of Jinan University, Guangzhou, China) and co-authors in JAMA Internal Medicine.

The LAMP trial included 636 patients (median age 63.5 years; 64% men) with type 2 diabetes who were admitted to 27 hospitals in China for minor AIS (NIHSS score ≤3 points) or high-risk TIA (ABCD² score ≥4 points).

Within 24 hours of stroke symptom onset, they were randomly assigned to receive once daily liraglutide (0.6 mg in week 1, 1.2 mg in week 2, and 1.8 mg thereafter; n=317) or placebo (n=319) for 90 days, each in addition to standard therapy for AIS and TIA.

The researchers report that, at 90 days, the cumulative incidence of recurrent ischemic or hemorrhagic stroke was significantly lower in the liraglutide group than in the control group, at 7.9% versus 13.8%. The difference between the two groups corresponded to a risk reduction of 44% with liraglutide.

Individuals in the liraglutide arm also had a significantly lower incidence of new clinical vascular events, namely ischemic stroke, hemorrhagic stroke, TIA, myocardial infarction, or vascular death (8.5 vs 15.7%), and were more likely to achieve excellent functional outcomes (modified Rankin Scale score ≤1 point; 87.3 vs 77.8%).

In terms of safety outcomes, people in the liraglutide and control groups experienced similar rates of symptomatic intracranial hemorrhage (0.3 vs 0.6%), hypoglycemia (7.6 vs 7.8%), and all-cause mortality (0.3 vs 1.3%), but had a significantly higher risk for gastrointestinal disorders such as nausea, vomiting, diarrhea, abdominal pain, and dyspepsia (18.9 vs 4.1%).

Xu et al conclude that although the results suggest that liraglutide treatment might reduce stroke recurrence risk in people with type 2 diabetes and minor AIS or high-risk TIA, the “findings should be interpreted with caution.” They say that early termination of the trial due to lower-than-expected enrolment and financial limitations, the small study population, and the low number of people with recurrent stroke, mean that “the possibility that these findings were due to chance cannot be excluded.”

The authors add: “Larger, adequately powered studies are needed to confirm the observed effects and establish their reliability.”

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JAMA Intern Med 2025; doi:10.1001/jamainternmed.2025.5684