ECE2021 Audio Eposter Presentations Pituitary and Neuroendocrinology (113 abstracts)
The GLP-1 receptor agonist dulaglutide reduces fluid intake in primary polydipsia: A randomised controlled trial
Bettina Winzeler 1 , Clara Sailer 1 , Coynel David 2 , Davide Zanchi 3 , Deborah Vogt 4 , Sandrine Urwyler 5 , Julie Refardt 5 & Christ-Crain Mirjam 5
1University Hospital of Basel, Endocrinology, Basel, Switzerland; 2Division of Cognitive Neuroscience, Department of Psychology, Switzerland; 3Stanford University Graduate School of Business, United States; 4Clinical Trial Unit, University of Basel and University Hospital Basel, Switzerland; 5Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Switzerland
Background
Primary polydipsia, characterized by excessive fluid intake, carries the risk of water intoxication and hyponatremia, but treatment options are scarce. Glucagon-like peptide-1 (GLP-1) reduces appetite and food intake. In experimental models, they also play a role in thirst and drinking behavior. The aim of this trial was to investigate whether GLP-1 receptor agonists reduce fluid intake in patients with primary polydipsia.
Methods
In this randomised, double-blind, placebo-controlled, 3-week crossover-trial, 34 patients with primary polydipsia received weekly dulaglutide (Trulicity) 1.5 mg and placebo (0.9% sodium chloride). During the last treatment week, patients attended an 8-hour evaluation visit with free water access. The primary endpoint was total fluid intake during the evaluation visits. The treatment effect was estimated using a linear mixed-effects model. In a subset of 15 patients and 15 matched controls, thirst perception and neuronal activity in response to beverage pictures were assessed by functional MRI.
Findings
Patients on dulaglutide reduced fluid intake by 490 ml [95%-CI –780, –199], P = 0.002, from 2950 ml [95% CI 2435, 3465] on placebo to 2460 ml [95% CI 1946, 2475] on dulaglutide (model estimates). This corresponds to a relative reduction of 17%. 24-hour urinary output was reduced by –943 ml [95%-CI –1473, –413], P = 0.001. Thirst perception in response to beverage pictures was higher in patients with primary polydipsia versus controls and lower on dulaglutide versus placebo, but functional activity was similar between groups and treatments.
Interpretation
GLP-1 receptor agonists reduce fluid intake and thirst perception in patients with primary polydipsia and could therefore be a novel treatment option for these patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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