The Potential Indirect Impact of GLP-1 Receptor Agonists in the Management of Fibromyalgia

Background/Objectives: Fibromyalgia (FM) syndrome is characterised by constant and pervasive musculoskeletal pain and may be comorbid with obesity. Glucagon Peptide-1 Receptor Agonists (GLP-1RAs) are relatively new pharmacotherapies developed for the treatment of type 2 diabetes mellitus (T2DM) and have been repurposed for the treatment of obesity. In addition to their well-established impact on glucose balance, new evidence indicates that GLP-1RAs may have anti-inflammatory properties beyond glycaemic regulation. The use of GLP-1RAs has been proposed to modulate the central pain pathways in patients with FM; however, few studies have directly evaluated their effects on central pain. Hence, the purpose of this study is to review the relationship between FM and obesity and to explore the potential role of GLP-1RAs in the management of FM. Methods: A literature search was conducted across four databases-PubMed/Medline, Cochrane, Google Scholar, and PEDro-up to May 2025. The literature was sparse, and no formal evaluation process was performed; however, papers were excluded if they failed to address either FM or GLP-1RAs. The key characteristics of each study were extracted and summarised in table form to enable efficient narrative synthesis. Results: Of the 56 included studies, 24 were preclinical reviews, 16 were clinical reviews, 8 examined preclinical animal models, and only 8 focused on human data, limited to retrospective analyses of data and self-reporting. There is some evidence that GLP-1RAs may reduce neuronal excitability, inhibit pain signalling, and decrease inflammation. Conclusions: However, no clinical trials directly evaluating GLP-1RAs in FM were identified, and therefore no conclusions can be drawn regarding clinical efficacy in FM, including in patients with comorbid obesity.