ArticleRMD open2026
Metabolic effects of GLP-1 receptor agonists in rheumatology patients and inflammatory outcomes: a single-centre retrospective cohort.
Article in RMD open, 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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8 authors.
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Abstract
backgroundObesity and type 2 diabetes are common in rheumatology, often exacerbated by glucocorticoids. Real-world data on glucagon-like peptide-1 receptor agonists (GLP-1RAs) in this setting remain limited.
objectivesTo evaluate the metabolic effectiveness and safety of GLP-1RAs in rheumatology outpatients, including inflammatory marker and subgroup analyses.
methodsSingle-centre retrospective study (October 2024-October 2025) including 119 patients (from 169 screened) treated with GLP-1RAs. Paired analyses were performed at 3, 6 and 12 months. Exploratory comparisons included participants with chronic inflammatory arthritis (n=46) and those with non-inflammatory disease (n=43).
resultsPatients had high baseline cardiometabolic burden (mean body mass index (BMI) 34.9±9.9 kg/m²; diabetes 96.6%). GLP-1RA initiation was associated with sustained weight loss: -4.0 kg, -4.5 kg and -7.7 kg at 3, 6 and 12 months (all p<0.001; -8.2% at 12 months), with 56.5% improving ≥1 BMI category. Haemoglobin A1c decreased by -0.97%, -0.69% and -0.91% (all p<0.001), alongside significant reductions in fasting glucose (up to -24.8 mg/dL; p<0.001). Lipid improvements included reductions in low-density lipoprotein-cholesterol (-12.2 mg/dL; p=0.006) and triglycerides (-21.7 mg/dL; p=0.007). At 12 months, erythrocyte sedimentation rate decreased significantly (p=0.023), while CRP showed a non-significant decline (p=0.076); both were significantly reduced in the inflammatory subgroup. No significant differences were observed between inflammatory and non-inflammatory groups in adjusted metabolic trajectories. Adverse events were mainly gastrointestinal (13.4%); pancreatitis (0.8%) and cholecystitis (1.7%) were rare. Discontinuation occurred in 6.7%. One death (mesenteric ischaemia) had unclear causality.
conclusionsGLP-1RAs were associated with meaningful metabolic improvements in patients with rheumatic diseases, with a favourable safety profile. Potential anti-inflammatory effects require confirmation in prospective studies.
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