An injection given to diabetics to lose weight could bring relief to 2,000 Britons suffering from ‘blind headaches’ caused by idiopathic intracranial hypertension

Thousands of Britons suffering from ‘blinding’ headaches have seen their attacks reduced by a third thanks to a drug used to treat diabetes.

At least 2,000 people in the UK suffer from idiopathic intracranial hypertension. The main symptom of the condition, in which excess fluid builds up around the brain, is a persistent, debilitating headache.

But in some cases, the increased pressure inside the skull can also damage the nerve that connects the eyes and brain, causing blindness.

Global cases of the condition have increased by 350 percent in the past decade, thought to be because the problem may be caused by obesity. There are no approved treatments, so doctors rely on drugs used to treat similar diseases.

Now researchers at the University of Birmingham have found that regular injections of exenatide, a drug that helps diabetics lose weight, are safe and effective.

Now researchers at the University of Birmingham have found that regular injections of exenatide, a drug that helps diabetics lose weight, are safe and effective

“This is the first drug found to have a powerful effect,” said Professor Alexandra Sinclair, consultant neurologist at University Hospitals Birmingham NHS Foundation Trust and principal investigator of the study. “It works directly on the part of the brain that produces fluid, slowing its release and thus lowering the pressure.”

Idiopathic intracranial hypertension is the result of excess cerebrospinal fluid—the protective cushion of fluid that surrounds the brain and spinal cord. Over time, this puts pressure on the delicate blood vessels that feed the brain and the optic nerves that carry visual information. The pressure causes severe headaches – which can be permanent – and vision loss. Patients may also suffer from nausea and tinnitus – constant ringing in the ears.

Experts are not sure what causes idiopathic intracranial hypertension, but it is thought to be an imbalance in the hormones that control the release of cerebrospinal fluid. Studies show that people with a higher body weight are at greater risk.

“The same hormonal problems that cause some people to gain weight can also be behind the condition,” says Prof. Sinclair.

A lumbar puncture is used for diagnosis. This is a procedure in which a sample of cerebrospinal fluid is taken through a needle in the lower back and the pressure is measured. Doctors also rule out other diseases that have similar symptoms, such as: B. Brain tumors.

With few treatments available, specialists often prescribe diuretics or water pills, such as the glaucoma drug acetazolamide, to help eliminate excess fluid – but half of patients experience side effects.

In extreme cases, surgery may be done to drain excess fluid from the brain. This is a last resort as risks include infection and cerebral haemorrhage.

But now the team from the University of Birmingham has carried out a 12-week clinical trial in which seven patients were given exenatide twice a day. At the start, the participants experienced headaches an average of 22 days per month. During the trial, the drug reduced pressure in the brain. The participants’ headache frequency was also reduced by 36 percent – ​​for up to 14 days. “We also saw an improvement in vision,” says prof. Sinclair.

The team is now conducting a follow-up study in 240 patients around the world and has reformulated the drug into a weekly injection.

Liz Formby “begged” Professor Sinclair to keep her on the drug as the trial came to an end. “My headaches went away and my vision stopped deteriorating,” she said.

Liz (63) was diagnosed with idiopathic intracranial hypertension in her late 30s after nearly losing her sight in a car accident.

“I had a headache that felt like my head was being ripped off,” she said.

An optometrist referred Liz to neurologists at her local hospital, where she underwent tests and received a diagnosis. Doctors prescribed painkillers and advised Liz to lose weight.

In 2018, she participated in a clinical trial of exenatide and injected herself twice a day for three months.

“I felt bad for the first two weeks,” Liz said, “but then the headache went away. Instead of four a week it was one and much less intense. My vision hasn’t improved, but it hasn’t gotten worse either.”

When the trial was over, Liz said, “The stabbing pain came back.”

She added: “People have asked why I took an experimental drug and put myself at risk. It was a good idea for me – I want to help doctors help people like me. And it’s clear that this drug help.”