Effect of Glucagon-Like Peptide 1 Receptor Agonists on Patients With Rheumatoid Arthritis

Glucagon-like peptide 1 receptor agonists (GLP-1RAs) are approved for weight loss, diabetes, and cardiovascular risk reduction. Despite widespread use, GLP-1RAs have not been well studied in patients with rheumatoid arthritis (RA). We examined the effects of GLP-1RAs on RA disease activity and cardiovascular risk profile in patients with RA and overweight or obesity.

We conducted a retrospective chart review study of patients with RA with a body mass index of ≥27 who were prescribed a GLP-1RA (semaglutide or tirzepatide). Between 2018 and 2024, 173 patients with RA were identified in the treatment group (prescribed and took a GLP-1RA), and 42 patients with RA were identified in the control group (prescribed but did not take GLP-1RA). Patients were assessed at three-month intervals for up to one year after prescription. Outcome measures included RA disease activity, cardiovascular risk markers, and patient-reported outcomes. Changes in outcome measures within and between groups were assessed with linear mixed effect models, with adjustments for baseline characteristics that differed significantly between groups.

GLP-1RA-treated patients experienced significantly greater reductions in RA disease activity, pain, body weight, total cholesterol, and glycosylated hemoglobin than controls (P < 0.05). Within the treatment group, there were also significant reductions in erythrocyte sedimentation rate, C-reactive protein values, low-density lipoprotein cholesterol values, and triglyceride values (P < 0.05). Nearly one-third of the treatment group discontinued the GLP-1RA during the study period, with the most common adverse effect being gastrointestinal issues.

This study suggests that the use of GLP-1RAs can improve RA disease activity and cardiovascular risk profile. Although further research is needed, this novel finding has significant clinical implications because it suggests that anti-obesity medications may improve both cardiovascular and RA outcomes.