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TOPLINE: 

GLP-1 receptor agonists, approved for weight loss, diabetes management, and cardiovascular risk reduction, reduced both disease activity and pain scores and improved cardiovascular risk profiles in patients with rheumatoid arthritis (RA) and overweight or obesity, a study showed.

METHODOLOGY:

• Researchers conducted a retrospective, observational study of patients with RA and a BMI of at least 27 to examine the effects of GLP-1 receptor agonist treatment on disease activity and cardiovascular risk profiles in this population.
• A total of 173 patients were prescribed GLP-1 receptor agonists (semaglutide or tirzepatide) and took them, whereas 42 patients were prescribed the drugs but did not take them (control group).
• Participants underwent assessments at 3-month intervals for up to 1 year after prescription.
• Outcome measures included RA disease activity, cardiovascular risk markers, and patient-reported outcomes.

TAKEAWAY:

• Patients treated with GLP-1 receptor agonists showed significantly greater reductions in disease activity (mean change score, -0.03 vs 0.20; P = .03), pain score (mean change, -0.6 cm vs 1.3 cm; P < .001), weight (mean change, -4.4 kg vs -1.2 kg; P < .001), total cholesterol levels (mean change, -10.3 mg/dL vs 0.3 mg/dL; P = .04), and A1c levels (mean change, -0.30% vs -0.01%; P = .03) than those in the control group.
• The GLP-1 receptor agonist group showed significant reductions in inflammatory markers (erythrocyte sedimentation rate and C-reactive protein levels) and lipid (low-density lipoprotein cholesterol and triglyceride) levels, whereas the control group did not.
• The reduction in pain did not correlate with weight loss.
• Approximately one third of patients in the treatment group discontinued GLP-1 receptor agonist treatment during the study period, with gastrointestinal adverse effects and insurance issues being the primary reasons for discontinuation.

IN PRACTICE:

"Our findings that [GLP-1 receptor agonists] are associated with decreases in RA disease activity, cardiovascular risk factors, and pain in patients with RA and overweight or obesity are promising and have substantial clinical implications for this patient population. They suggest that this drug class, typically used for managing diabetes and obesity, may serve as a dual-purpose treatment for patients with RA, addressing both systemic inflammation and associated comorbidities, such as cardiovascular disease, which is especially prevalent in patients with [rheumatoid arthritis and obesity] and remains the leading cause of death in patients with RA overall," the authors wrote.

SOURCE:

The study was led by David A. Kellner, MD, David Geffen School of Medicine, University of California, Los Angeles. It was published online on September 11, 2025, in ACR Open Rheumatology.

LIMITATIONS: 

The single-center retrospective design, limited sample size, and potential unmeasured confounding factors that may have influenced RA outcomes are key limitations of this study. Additionally, electronic health record progress notes often lacked composite RA disease activity scores. 

DISCLOSURES:

The study was supported by grants from the National Center for Advancing Translational Sciences of the National Institutes of Health. Some authors declared receiving consultancy fees, speaking fees, honoraria, and other ties with various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.