ABSTRACT NUMBER: ESOC2026LT58 LT58 - GLUCAGON-LIKE PEPTIDE 1 RECEPTOR AGONIST IN ACUTE LARGE VESSEL OCCLUSION STROKE TREATED BY REPERFUSION THERAPIES (GALLOP-2) – A MULTICENTER, RANDOMIZED, OPEN-LABEL, BLINDED END-POINT TRIAL

Abstract Background and aims Results from the GALLOP study indicated that semaglutide, a glucagon-like peptide-1 receptor agonist, could potentially improve 90-day functional recovery for large vessel occlusion (LVO) patients who received endovascular thrombectomy (EVT) without intravenous thrombolysis (IVT). Given its potential as a neuroprotective agent, a larger-scale trial (GALLOP-2) was conducted to validate the efficacy and safety of semaglutide treatment in these patients. Methods In this investigator-initiated, multicenter, prospective, randomized, open-label, blinded endpoint assessment (PROBE) trial conducted at 19 centers in China, we assigned patients with acute ischemic LVO who presented within 24 hours after onset and did not receive IVT to two groups: the semaglutide group received subcutaneous semaglutide (0.5 mg) before and 7 days after EVT, while the control group received EVT alone. The primary efficacy outcome was the ordinal shift of modified Rankin Scale (mRS) at 90 days. The safety outcomes were symptomatic intracranial hemorrhage and death at 90 days. Results A total of 195 patients were assigned to semaglutide goup and 195 to control group. At 90 days, semaglutide group had superior functional outcome compared with control group (common odds ratio, 0.67; 95% confidence interval, 0.47 to 0.96; P=0.029). Symptomatic intracranial hemorrhage rates were 10.8% in semaglutide group and 5.7% in the control group (P=0.073), with 90-day mortality were 17.4% vs. 14.4% (P=0.407), respectively. Conclusions In LVO patients who did not receive IVT within 24 hours after onset, subcutaneous semaglutide improved functional outcomes and was well-tolerated with no observed harm. (NCT 06788626.) Conflict of interest