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Pharmaceutics
Special Issues
GLP-1 Receptor Agonists: Current Understanding and Emerging Therapeutic Horizons
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GLP-1 Receptor Agonists: Current Understanding and Emerging Therapeutic Horizons

A special issue of Pharmaceutics (ISSN 1999-4923). This special issue belongs to the section "Clinical Pharmaceutics".

Deadline for manuscript submissions: 30 July 2026 | Viewed by 1027

Special Issue Editor

Prof. Dr. Maria Bogdan

E-Mail Website
Guest Editor
Discipline of Pharmacology, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
Interests: inflammation; anti-inflammatory drugs; depression; antidepressant drugs; biomarkers; drug delivery systems; in vivo animal models
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Glucagon-like peptide-1 (GLP-1) receptor agonists have emerged as a cornerstone in the management of type 2 diabetes mellitus, offering significant glycemic control, weight reduction, and cardiovascular benefits. Recent advances have expanded their potential therapeutic applications beyond glycemic regulation, including obesity management, non-alcoholic steatohepatitis (NASH), and neurodegenerative disorders. The molecular mechanisms underlying their pleiotropic effects involve enhanced insulin secretion, delayed gastric emptying, appetite suppression, and anti-inflammatory pathways. Despite substantial progress, key challenges remain regarding long-term safety, patient adherence, and individualized therapy. Future research is focused on optimizing pharmacokinetic profiles, exploring novel delivery systems, and expanding indications through combination therapies and dual- or tri-agonist strategies. GLP-1 receptor agonists thus represent a rapidly evolving therapeutic class with far-reaching implications for metabolic and chronic disease management.

We invite researchers and clinicians to contribute original research and comprehensive reviews that explore cutting-edge approaches to all facets of GLP-1 receptor agonists treatment.

Prof. Dr. Maria Bogdan
Guest Editor

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Keywords

  • GLP-1 receptor agonists
  • nanotechnology
  • pharmacokinetics
  • delivery systems
  • advanced therapies
  • adherence
  • drug repurposing

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Published Papers (2 papers)

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Review

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14 pages, 1389 KB  
Review
Liraglutide and Exenatide in Alzheimer’s Disease and Mild Cognitive Impairment: A Systematic Review and Meta-Analysis of Cognitive Outcomes
by Paula Santos, Alberto Souza Sá Filho, Vicente Aprigliano, Amanda G. Duarte, Natã Alegransi Ribeiro, Katia Marques Lombardo, James Oluwagbamigbe Fajemiroye, Artur Prediger Buchholz, Victor Renault Vaz and Gaspar R. Chiappa
Pharmaceutics 2026, 18(1), 69; https://doi.org/10.3390/pharmaceutics18010069 - 4 Jan 2026
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Abstract
Background/Objective: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) exhibit neuroprotective properties in preclinical models of Alzheimer’s disease (AD), reducing amyloid accumulation, neuroinflammation, and insulin resistance within the brain. However, clinical evidence regarding their cognitive effects in AD and mild cognitive impairment (MCI) remains inconclusive. [...] Read more.
Background/Objective: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) exhibit neuroprotective properties in preclinical models of Alzheimer’s disease (AD), reducing amyloid accumulation, neuroinflammation, and insulin resistance within the brain. However, clinical evidence regarding their cognitive effects in AD and mild cognitive impairment (MCI) remains inconclusive. To evaluate the effects of GLP-1 RAs on cognitive outcomes in patients with AD or MCI due to AD. Methods: A systematic review was conducted according to PRISMA 2020 and registered in PROSPERO (CRD420251143171). Although the original registry was broad, the identification of a small set of homogeneous randomized controlled trials (RCTs) during screening, prior to data extraction, allowed for a random-effects meta-analysis of cognitive outcomes. RCTs enrolling adults with clinically or biomarker-confirmed AD or MCI were included. Interventions comprised liraglutide or exenatide compared with placebo. Standardized mean differences (SMD) in global cognitive scores were pooled using a random-effects model (restricted maximum likelihood [REML] estimator with Hartung–Knapp adjustment). Results: Three randomized trials (n = 278 participants; 51% women; mean age 68 ± 7 years) met inclusion criteria. Treatment duration ranged from 26 weeks to 18 months. Pooled analysis revealed no significant effect of GLP-1 RAs on global cognition compared with placebo −0.21 (95% CI −0.81 to 0.38; I2 = 47%; τ2 = 3.77). Sensitivity analyses restricted to liraglutide or studies ≥ 12 months yielded similar results. Conclusions: Current randomized evidence does not support cognitive improvement with GLP-1 RAs in AD or MCI. Full article
(This article belongs to the Special Issue GLP-1 Receptor Agonists: Current Understanding and Emerging Therapeutic Horizons)
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26 pages, 3313 KB  
Systematic Review
The Effect of GLP-1 Agonists on Patients with Metabolic-Associated Steatotic Liver Disease: A Systematic Review and Meta-Analysis
by Denisia Adelina Tornea, Christian Goldis, Alexandru Isaic, Alexandru Catalin Motofelea, Alexandra Christa Sima, Tudor Ciocarlie, Andreea Crintea, Razvan Gheorghe Diaconescu, Nadica Motofelea and Adrian Goldis
Pharmaceutics 2026, 18(1), 86; https://doi.org/10.3390/pharmaceutics18010086 - 9 Jan 2026
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Abstract
Background: Metabolically associated fatty liver disease (MASLD) constitutes a major burden. Glucagon-like peptide-1 agonists (GLP-1) could improve hepatic steatosis as well as weight loss. However, the effect of GLP-1 agonists on patients with and without diabetes and the effect of newer drugs [...] Read more.
Background: Metabolically associated fatty liver disease (MASLD) constitutes a major burden. Glucagon-like peptide-1 agonists (GLP-1) could improve hepatic steatosis as well as weight loss. However, the effect of GLP-1 agonists on patients with and without diabetes and the effect of newer drugs (dual and triple agonists) are unclear. Objective: To investigate the effect of GLP-1 agonists, including dual and triple agonists, in patients with metabolic-associated liver steatosis and steatohepatitis, while exploring their effect on patients with and without type 2 diabetes. Methods: We searched PubMed, Scopus, and Web of Science in October 2025 for randomized parallel controlled trials that investigated the effect of GLP-1 agonists in patients with MASLD or metabolic-associated steatohepatitis (MASH). We assessed the quality of the included studies using Cochrane ROB2. We performed the analysis using RevMan 5.4. We performed subgroup analysis based on the status of diabetes, the control group, and the class of GLP-1 agonist (single, dual, or triple). Results: We included twenty studies. Compared to the control group, GLP-1 agonists were associated with a statistically significant increase in the resolution of MASH without worsening fibrosis (RR 3.03, p < 0.0001) and at least one stage of liver fibrosis without the worsening of MASH compared to the control group (RR: 1.45, p < 0.00001). GLP-1 agonists were associated with a statistically significant weight reduction (SMD −1.11, p < 0.0001), glycosylated hemoglobin (SMD −0.81, p < 0.00001), levels of aspartate aminotransferase (SMD −0.48, p = 0.008), and alanine aminotransferase (SMD −0.54, p = 0.008). However, in patients without type 2 diabetes, GLP-1 agonists had no significant effect on weight loss (SMD −0.97, p = 0.12) or improvement in fibrosis (RR 1.54, p = 0.24). There was a statistically significant increase in the overall adverse events (RR 1.10, p < 0.00001), while there was no significant difference in serious adverse events (p = 0.35). Conclusions: GLP-1 agonists improved liver fibrosis, steatohepatitis, weight loss, HbA1c, and liver enzymes in patients with MASLD or MASH. Overall, GLP-1 agonists were associated with a significantly higher risk of adverse events compared to the control, while serious adverse events were comparable between both groups. There was no significant effect on weight loss or improvement in fibrosis in patients without type 2 diabetes. However, there was a limited number of studies in this population. Thus, further research is needed before recommendations can be made for this subgroup. Full article
(This article belongs to the Special Issue GLP-1 Receptor Agonists: Current Understanding and Emerging Therapeutic Horizons)
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