GLP-1 RA May Reduce Stroke Recurrence in People with Type 2 Diabetes

Treatment with the glucagon-like peptide-1 receptor agonist (GLP-1 RA) liraglutide may reduce the risk of recurrent stroke and improve short-term functional outcomes in people with type 2 diabetes mellitus (T2D) who previously experienced a minor acute ischemic stroke or high-risk transient ischemic attack (TIA), according to new research published in JAMA Internal Medicine.

The prospective, multicenter, randomized LAMP clinical trial (NCT03948347) included 636 participants with T2D from 27 hospitals in China. Within 24 hours of the onset of symptoms of ischemic stroke or TIA, participants were randomized to receive standard therapy or standard therapy with the addition of liraglutide treatment, which was initiated at 0.6 mg daily and titrated to 1.8 mg over 3 weeks for a 90-day treatment course.

Key results from the trial included the following:

• Within 90 days, stroke recurrence occurred in 7.9% of individuals who received standard therapy with liraglutide treatment (n=25) and 13.8% of those who received standard therapy alone (n=44) (hazard ratio [HR], 0.56; 95% CI, 0.34 to 0.91; P=.02).
• Excellent functional recovery (defined as a modified Rankin Scale score of ≤1) was achieved by 87.3% of patients in the liraglutide group (n=274) vs 77.8% in controls (n=246) (odds ratio [OR], 1.95; 95% CI, 1.28–3.00; P = .002).
• Symptomatic intracranial hemorrhage and mortality were rare and occurred at similar rates across groups.
• Gastrointestinal symptoms (nausea, vomiting, diarrhea) occurred more frequently in liraglutide-treated participants than those receiving standard therapy alone (18.9% vs 4.1%).

The study authors noted that the study was underpowered because enrollment was terminated early due to low enrollment and financial limitations. The researchers stated that larger trials will be needed to confirm these findings and establish liraglutide’s role in secondary stroke prevention.

Sources: Zhu H, Yang B, Lu L, et al. Liraglutide in acute minor ischemic stroke or high-risk transient ischemic attack with type 2 diabetes: the lamp randomized clinical trial. JAMA Intern Med. Published online November 3, 2025. doi:10.1001/jamainternmed.2025.5684