Repurposing incretin therapies: a narrative review of emerging indications across cardiometabolic, liver, kidney, neurological, psychiatric, and other systems.

Incretin therapies have revolutionized the management of type 2 diabetes and obesity. Recent evidence suggests that these agents modulate key pathways involved in cardiovascular, renal, hepatic, neuropsychiatric, and reproductive health. In this narrative review, we examine the role of incretin-based therapies in chronic kidney disease, heart failure with preserved ejection fraction, metabolic dysfunction-associated steatotic liver disease, neurodegenerative and cognitive disorders, substance use disorder, obstructive sleep apnea, knee osteoarthritis, and polycystic ovary syndrome. The mechanisms underlying these benefits appear to extend beyond glucose and weight regulation, including anti-inflammatory, neuroprotective, and cardiorenal effects. We summarize key clinical trial data, highlight knowledge gaps, and discuss future directions for integrating incretin-based therapies into broader clinical practice.