GLP-1 receptor agonists in systemic lupus erythematosus: a scoping review

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly recognised for benefits beyond glycaemic control, including anti-inflammatory, anti-atherogenic and potential immunomodulatory effects. Given the high burden of metabolic dysfunction, accelerated cardiovascular disease and chronic systemic inflammation in systemic lupus erythematosus (SLE), significant interest has emerged regarding their therapeutic role in this population.

We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided scoping review of PubMed, Embase, Scopus and the Cochrane Library from database inception to April 2026, including peer-reviewed clinical studies, case series, case reports and relevant research evaluating GLP-1 RAs in SLE while excluding conference abstracts and unpublished material.

Fourteen studies were included, comprising narrative reviews, mechanistic analyses, editorials and case reports. Across these studies, GLP-1 RAs demonstrated consistent anti-inflammatory, metabolic and endothelial effects relevant to SLE, with mechanistic data suggesting reductions in cytokine signalling, oxidative stress and macrophage activation. Current evidence specific to SLE is largely derived from small observational cohorts, retrospective analyses and isolated case reports, while much of the supportive anti-inflammatory and immunomodulatory data originate from preclinical studies or extrapolated from the broader rheumatic disease populations. GLP-1 RAs appear to have an acceptable safety profile in autoimmune populations, although drug-induced lupus was reported in two case studies.

Collectively, findings from the included studies suggest that GLP-1 RAs may provide metabolic and anti-inflammatory benefits in SLE with an acceptable safety profile; however, clinical data specific to SLE remain limited and large high-quality prospective clinical trials are required to refine therapeutic indications, optimal patient selection and immunological effects.