GLP-1 RA Use Improves Disease Activity, Cardiovascular Risk in Rheumatoid Arthritis

New research is shedding light on the benefits of GLP-1 RA use among people with rheumatoid arthritis (RA) and overweight or obesity, highlighting improvements in disease activity and cardiovascular risk profile.1

Findings from the single-center, retrospective, observational study of electronic health record data suggest GLP-1 RAs may be useful tools for individuals with RA based on observed decreases in RA disease activity, pain, and cardiovascular risk factors.1

GLP-1 RAs have taken medicine by storm in recent years. Since semaglutide was first approved for the treatment of type 2 diabetes in 2017, the agent has earned several additional indications for obesity, cardiovascular risk reduction, chronic kidney disease in type 2 diabetes, and most recently, the treatment of metabolic dysfunction-associated steatohepatitis (MASH) with moderate to advanced fibrosis.2,3

“Although [GLP-1 RAs] are increasingly used in the general population, there is a paucity of data on their clinical effects in patients with RA,” Veena Ranganath, MD, MS, co-director of the UCLA Masters of Science in Clinical Research Program and director of the Rheumatology Fellowship Musculoskeletal Ultrasound Training Program, and colleagues wrote.1 “Specifically, their impact on RA disease activity and cardiovascular risk factors in this patient population remains poorly characterized.”

To address this gap in research, investigators conducted a single-center, retrospective, observational study using data from 2018 to 2024 for a cohort of patients with RA with a body mass index of ≥27 who were prescribed either semaglutide or tirzepatide. A total of 173 patients took the prescribed GLP-1RA of interest, forming the treatment group. A control group comprised 42 patients who were prescribed but did not take a GLP-1RA during the same period.1

Patients were assessed at 3-month intervals for up to 1 year after prescription for RA disease activity, cardiovascular risk markers, and patient-reported outcomes.1

At baseline, investigators noted the treatment and control groups did not differ significantly in terms of BMI, RA disease activity, disease-modifying antirheumatic drug use, or prednisone use. However, they called attention to differences in baseline pain visual analog scale (VAS) scores, prevalence of hypertension and diabetes, HbA1c and serum triglyceride values, and the number of White patients between the 2 groups.1

Results showed the treatment group experienced significantly greater reductions in RA disease activity (mean change score, −0.03 vs +0.2; P = .03), VAS pain score (−0.6 cm vs +1.3 cm; P <.001), weight (−4.4 kg vs −1.2 kg; P <.001), total cholesterol values (−10.3 mg/dL vs +0.3 mg/dL; P = .04), and HbA1c values (−0.3% vs −0.01%; P = .03).1

Within the treatment group, investigators observed significant reductions in erythrocyte sedimentation rate (−3.0 mm/hr; P = .004), C-reactive protein (−0.6 mg/dL; P = .004), low-density lipoprotein cholesterol (−7.3 mg/dL; P = .002), and triglyceride values (−16.4 mg/dL; P = .004), whereas there were no significant reductions in these variables within the control group. Of note, in the between-group mixed effects model fitted to all data, the change in these variables did not differ significantly between groups.1

Of the 173 patients in the treatment group, 50 (29%) discontinued the GLP-1RA during the study period, with the most common reasons for discontinuation being gastrointestinal adverse effects and insurance issues.1

“Our study is among the first to assess the effects of GLP-1RAs on patients with RA, and our findings suggest that they may beneficially impact RA care in several important ways,” investigators concluded.1 “Further study in the form of prospective trials is needed to better characterize their benefits and risks in this patient population.”

References

1. Kellner DA, Dente E, Tran V, et al. Effect of Glucagon-Like Peptide 1 Receptor Agonists on Patients With Rheumatoid Arthritis. ACR Open Rheumatology. https://doi.org/10.1002/acr2.70103

2. Brooks A. FDA Approves Semaglutide (Ozempic) for Type 2 Diabetes, Chronic Kidney Disease. HCPLive. January 28, 2025. Accessed September 16, 2025. https://www.hcplive.com/view/fda-approves-semaglutide-ozempic-type-2-diabetes-chronic-kidney-disease

3. Brooks A. FDA Approves Semaglutide (Wegovy) Injection 2.4 mg for Noncirrhotic MASH. HCPLive. August 15, 2025. Accessed September 16, 2025. https://www.hcplive.com/view/fda-approves-semaglutide-wegovy-injection-2-4-mg-for-noncirrhotic-mash