Metabolic effects of GLP-1 receptor agonists in rheumatology patients and inflammatory outcomes: a single-centre retrospective cohort

Why clinicians should know about it

• Picked for Rheumatology (paper of the day, 26 August 2026): GLP‑1RA improves metabolic and inflammatory markers in rheumatology

Abstract

BACKGROUND: Obesity 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. OBJECTIVES: To evaluate the metabolic effectiveness and safety of GLP-1RAs in rheumatology outpatients, including inflammatory marker and subgroup analyses. METHODS: Single-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). RESULTS: Patients 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. CONCLUSIONS: GLP-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.

Abstract as published, via PubMed.