Improvement in chronic lymphedema in a gynecologic cancer survivor after starting GLP-1 receptor agonist therapy: A case report

BACKGROUND: Lower extremity and pelvic lymphedema is a difficult-to-treat and often debilitating sequela of gynecologic cancer treatment. Management has traditionally relied on lymphedema therapy, home manual massage drainage, compression garments, and pumps. These treatments can be time and labor intensive, and often fail to adequately manage symptoms. Patients with poorly controlled lymphedema are at increased risk of skin breakdown, infection, pain, and impaired mobility, all of which negatively impact quality of life. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are new medications being used for the treatment of type 2 diabetes and obesity, but there are reports of benefits for lymphedema as well. Thus far, most case reports have focused on patients with upper extremity lymphedema. CASE PRESENTATION: Here, we present a case of chronic severe lower extremity and pelvic lymphedema which was reversed with use of a GLP-1 RA. Previously our patient had severe, debilitating lymphedema for almost two decades. On starting a GLP-1 RA, she had marked improvement in her lymphedema symptoms, function, and quality of life. CONCLUSIONS: GLP-1 RAs show promising benefit as a new treatment for chronic, uncontrolled lymphedema; however, there are currently no reported uses in lower extremity edema. This case report provides one example of GLP-1 RA effectiveness for lower extremity and pelvic edema and supports the case for further dedicated research.