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GLP-1 receptor agonist-induced polyarthritis: a case report
Maria Luisa Ambrosio1, Matteo Monami, Lavinia Sati
1Geriatric Cardiology, Azienda Ospedaliero-Universitaria Careggi, Via delle Oblate 4, 50141, Florence, Italy.
Acta Diabetologica
|October 26, 2013
Summary
A case of seronegative polyarthritis occurred in a patient treated with a GLP-1 receptor agonist, suggesting a potential link between these diabetes medications and joint inflammation. Symptoms resolved after drug withdrawal, indicating a possible drug-induced mechanism.
Area of Science:
- Endocrinology
- Rheumatology
- Pharmacology
Background:
- Dipeptidyl peptidase-4 (DPP-4) inhibitors have been occasionally linked to bilateral, symmetrical, seronegative polyarthritis.
- The underlying mechanism for DPP-4 inhibitor-associated polyarthritis is thought to involve a direct effect on inflammatory cells expressing the enzyme.
Observation:
- A 42-year-old male with type 2 diabetes experienced bilateral arthralgia affecting multiple joints after six months of treatment with metformin and liraglutide (a GLP-1 receptor agonist).
- Laboratory tests revealed elevated erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and leukocytes, with negative results for rheumatoid factor, anticyclic citrullinated protein antibody, antinuclear antibodies, and Lyme disease antibodies.
Findings:
- Discontinuation of liraglutide led to complete resolution of arthralgia within one week.
- Inflammatory markers (ESR, CRP, fibrinogen, leukocytes) normalized following liraglutide withdrawal.
Implications:
- This case suggests a potential association between GLP-1 receptor agonists and polyarthritis, distinct from the mechanism proposed for DPP-4 inhibitors.
- The findings warrant further investigation into the role of GLP-1 receptor stimulation in drug-induced polyarthritis.
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