Can glucagon-like peptide-1 (GLP-1) analogues make neuroprotection a reality?

Abstract

Currently, ischemic stroke remains one of the most costly and devastating clinical syndromes, accounting for 9% of all deaths and being the second leading cause of death in the world (Davidson et al., 2018). Approximately 20% of strokes are caused by intracerebral hemorrhage, while the other ~80% are classified as ischemic. With the discovery of thrombolysis, reperfusion therapy became an option for the treatment of ischemic stroke. More recently, endovascular recanalization with mechanical thrombectomy has brought about a paradigm shift in the optimal management of patients with large vessel occlusion. Importantly, early reperfusion is the only therapy that is proven to limit infarct size in patients with acute ischemic stroke. However, despite a successful recanalization being achieved in more than 70% of patients treated with mechanical thrombectomy +/– intravenous tissue recombinant plasminogen activator, functional independence (modified Rankin score 0–2 at 3 months after ischemic stroke) is obtained only in ~45% of cases. This reveals the further need to develop new adjunctive neuroprotective treatment strategies alongside reperfusion therapy.