ArticleClinical rheumatology2026
GLP-1-based therapy and ICD-10-documented heart failure or respiratory failure events in non-diabetic adults with rheumatoid arthritis and obesity: a TriNetX federated cohort study.
Article in Clinical rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
INTRODUCTION/
objectivesGlucagon-like peptide-1 (GLP-1)-based therapies have emerged as a major advance in cardiometabolic care; however, no prospective outcomes data exist for these agents in non-diabetic adults with rheumatoid arthritis (RA) and obesity. We examined whether GLP-1-based therapy was associated with first post-landmark ICD-10-documented heart failure (HF) or respiratory failure (RF) events.
methodsWe conducted a retrospective cohort study in the TriNetX US Collaborative Network. Adults with RA, body mass index ≥ 30 kg/m
resultsAfter matching, 3483 patients remained per cohort, with all standardized mean differences < 0.10. During days 91-365, the primary endpoint occurred in 23/3176 GLP-1 users (0.7%) and 57/3144 never-users (1.8%) (hazard ratio (HR): 0.48; 95% confidence interval (CI): 0.30-0.78; p = 0.002; absolute risk difference: - 1.1 percentage points). The HF and RF components showed directionally similar associations. Findings were directionally similar at extended follow-up and, where estimable, in the calendar-time-restricted analysis. Bias probes showed no differential utilization.
conclusionsGLP-1-based therapy was associated with substantially lower hazards of first post-landmark ICD-10-documented HF or RF events. These observations, while compelling, are hypothesis-generating and require prospective validation before informing clinical use. Key Points • In a propensity score-matched TriNetX cohort of non-diabetic adults with rheumatoid arthritis and obesity, GLP-1-based therapy was associated with a lower hazard of first post-landmark ICD-10-documented heart failure or respiratory failure events. • In absolute terms, the primary composite occurred in 0.7% of GLP-1 users and 1.8% of never-users during days 91-365, corresponding to approximately one fewer event per 100 patients. • Heart failure and respiratory failure, analyzed separately, showed directionally consistent lower hazards, although event counts were small. • The findings provide preliminary RA-specific evidence for a prospective study, but they should not be used to guide treatment decisions.
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