Could a medication designed for weight loss change how we think about migraine prevention?
In this episode, host Diana Langworthy sits down with returning guest Dr. Natalie Heinrich, PharmD and student contributor Nena Abosi, PharmD Candidate 2026 to unpack a 2025 Headache pilot study evaluating liraglutide as an add-on therapy for adults with obesity and high-frequency or chronic migraine. The team breaks down study design, results, and limitations while questioning whether the observed benefit stems from weight loss, intracranial-pressure changes, or something else entirely.

• Study Design: Prospective open-label pilot (n = 31) using liraglutide 1.2 mg daily × 12 weeks in adults with BMI > 30 kg/m² and ≥ 8 headache days/month unresponsive to ≥ preventives.
• Results: Headache days decreased by ~9 per month (≈ 50 % reduction); disability scores improved significantly, but BMI change was minimal.
• Mechanism: Benefit appeared independent of weight loss—raising curiosity about GLP-1 effects on intracranial pressure and CGRP release.
• Tolerability: Mild GI symptoms (~40 %), no discontinuations.
• Caveats: Small sample, no control group, single center — results are hypothesis-generating, not practice-changing.
• Clinical Pearl: Pilot studies like this spark conversation and awareness for emerging mechanisms while reminding clinicians to stay evidence-curious.

• Braca S, Russo CV, Stornaiuolo A, et al. Effectiveness and tolerability of liraglutide as add-on treatment in patients with obesity and high-frequency or chronic migraine: A prospective pilot study. Headache. 2025; 00: 1–8. doi:10.1111/head.14991

• Natalie Heinrich, PharmD, BCPS – Clinical Pharmacist in Neurology, M Health Fairview
• Nena Abosi, PharmD Candidate (2026) – University of Minnesota College of Pharmacy

• Diana Langworthy, PharmD, BCPS – Associate Professor, University of Minnesota College of Pharmacy

Have a study you'd like us to decode on a future episode? Send it our way at whatsitworthpodcast@gmail.com.
We'd also love to hear your thoughts—drop a comment, share your takeaways, or let us know how you're using this evidence in practice.

New population-based study suggests SGLT2 inhibitors and GLP-1 receptor agonists may reduce COPD exacerbations in patients with type 2 diabetes.

In this episode of What's It Worth?, we examine a large real-world study assessing whether glucose-lowering medications influence the risk of COPD exacerbations in patients with type 2 diabetes and chronic obstructive pulmonary disease. We focus on SGLT2 inhibitors and GLP-1 receptor agonists and discuss whether potential pulmonary benefits should influence drug selection in patients with both conditions.

Guest: Ashley Wilke, PharmD — PGY2 Critical Care Pharmacy Resident at M Health Fairview East Bank Hospital.

Study at a Glance

• Design: Retrospective cohort study using nationwide claims and registry data
• Population: Adults with type 2 diabetes and COPD initiating glucose-lowering therapy
• Exposures: SGLT2 inhibitors, GLP-1 receptor agonists, DPP-4 inhibitors
• Primary outcome: COPD exacerbations requiring hospitalization or systemic steroids
• Key Finding: SGLT2 inhibitors and GLP-1 receptor agonists were associated with a lower risk of COPD exacerbations compared with DPP-4's
• KEY Caveats: Results are observational and this study cannot prove causality - only association.
• Tune in for our conclusions when we ask, "What's it Worth?"!

Key teaching points

1. SGLT2 inhibitors and GLP-1 RAs may reduce pulmonary inflammation and fluid overload, potentially contributing to fewer exacerbations.

2. In a patient with both COPD and type 2 diabetes, these agents may offer meaningful extra-glycemic benefits.

3. This evidence supports shared decision-making, not mandatory therapy selection

4. Pharmacists can identify dual-benefit opportunities and tailor therapy based on comorbidities, cardiovascular risk, and exacerbation history.

Citation:
Patorno E, Feldman HA, Bykov K, et al. Glucose-lowering medications and risk of chronic obstructive pulmonary disease exacerbations in type 2 diabetes. JAMA Intern Med. 2025;185(4):405-414. doi:10.1001/jamainternmed.2024.7811

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Can stable patients with uncomplicated Staphylococcus aureus bacteremia finish therapy by mouth? The SABATO trial tested early oral switch versus full-course IV therapy.

In this episode, we decode the SABATO trial - a randomized, open-label, non-inferiority study that compared continued intravenous (IV) antibiotics with an early oral switch in low-risk Staphylococcus aureus bacteremia (SAB).

Guest: Dr. Jen Ross, PharmD, BCIDP — Clinical Infectious Diseases Pharmacist at M Health Fairview

Study at a glance

• Design: Multicenter, randomized, open-label, non-inferiority trial
• Population: 213 adults with uncomplicated S. aureus bacteremia after > 5-7 days of IV therapy and no signs of complicated infection
• Intervention: Early oral switch (e.g., TMP-SMX, clindamycin, linezolid)
• Comparator: Continued full-course IV therapy
• Primary endpoint: SAB-related complications within 90 days
• Results: Primary outcome occurred in 13% of patients in oral group vs 12% in IV group which met non-inferiority criteria
• KEY Caveats: Did not include patients with IV drug use; stopped study early which can skew towards a significant finding; changed NI margin midway through which leads to accepting a wider risk of difference.
• Tune in to hear our perspectives on what this study is worth!?

Citation:
Kaasch AJ et al. Early Oral Switch vs Continued IV Therapy for Low-Risk Staphylococcus aureus Bacteremia (SABATO Trial). Lancet Infect Dis. 2024; 24(3): 310-320. DOI 10.1016/S1473-3099(24)00032-X.

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🎧 Email me at whatsitworthpodcast@gmail.com if you have an article suggestion for me to decode!