GLP-1 receptor agonists — medicines like semaglutide, tirzepatide, and liraglutide — are best known for treating type 2 diabetes and supporting weight loss. But new research presented at the American College of Rheumatology (ACR) 2025 Annual Meeting suggests these drugs may also benefit people with rheumatic diseases, such as rheumatoid arthritis (RA) and psoriatic arthritis (PsA).
Here are some of the most interesting findings:
In a large retrospective (looking back) study using global health records, people with psoriatic arthritis who took GLP-1 receptor agonists (a class of drugs used for weight loss and diabetes) were compared with similar patients who did not take these drugs. After matching for age, diagnosis, medications, etc., the group taking GLP-1 agents had a lower risk of serious heart problems (major adverse cardiac events) and lower overall death rates than the non-users. The authors suggest that GLP-1 drugs might be a helpful add-on in psoriatic arthritis patients who also have obesity or type 2 diabetes, but they caution more research is needed to understand exactly why and to confirm long-term benefits.
The researchers compared people starting GLP-1 receptor agonists (used for diabetes) with those starting DPP-4 inhibitors, using a large global medical database and matching groups so they were similar in age, sex, BMI, lab values, other illnesses, etc. ACR Meeting Abstracts Over one year, the group on GLP-1 drugs had lower rates of developing rheumatoid arthritis, gout, and osteoarthritis compared to the DPP-4 group. ACR Meeting Abstracts They did not see a significant difference for systemic lupus, ankylosing spondylitis, scleroderma, or psoriatic arthritis. ACR Meeting Abstracts The authors suggest that GLP-1 receptor agonists may have protective effects against some rheumatic diseases, beyond their role in diabetes, but more research is needed to confirm and understand mechanisms.
Researchers looked at medical records of adults with rheumatoid arthritis (RA) and split them into two groups: those who were prescribed semaglutide (a GLP-1 receptor agonist) and those who were not. They matched the two groups by age, sex, BMI, presence of diabetes, smoking status, mood disorders, etc., to make comparisons fair. Over periods of 30 days, 90 days, and one year, the semaglutide group showed lower risks of RA flare symptoms: joint stiffness, pain, swelling, and synovitis (inflammation of the joint lining). For example, at 30 days the risk ratios for stiffness, pain, and swelling were 0.635, 0.605, and 0.588 respectively (meaning about 36–41 % lower risk). After one year, the reductions were smaller but still statistically significant for all these outcomes. The authors suggest semaglutide may help reduce disease activity in RA (beyond its metabolic effects), perhaps via anti-inflammatory actions. They emphasize that more controlled studies are needed to confirm whether semaglutide could be used as a therapeutic adjunct in RA.
Researchers used a large U.S. rheumatology registry (RISE) to look at patients with rheumatic or musculoskeletal diseases (RMDs) who started on GLP-1 receptor agonists (specifically semaglutide or tirzepatide). ACR Meeting Abstracts They tracked how much weight people lost over 6, 12, and 18 months, and plan to examine how this might affect disease activity, pain, and function. ACR Meeting Abstracts Among ~60,000 RMD patients, most (67 %) had diabetes; average BMI was ~36.3. ACR Meeting Abstracts Over 12 months, patients without diabetes lost more weight than those with diabetes; users of tirzepatide lost about 1.7 % more weight (adjusted) than semaglutide users. ACR Meeting Abstracts Weight reduction plateaued after 12 months, with slight regain by 18 months in some. ACR Meeting Abstracts The authors note that increasing use of these agents shows promise, and ongoing work is evaluating how medication-driven weight loss might translate into better pain, function, and disease control in rheumatic diseases.
In people with rheumatoid arthritis (RA) who are obese but don’t have diabetes, researchers looked at medical-record data and matched two groups: one group started GLP-1 receptor agonists (like semaglutide, liraglutide, tirzepatide), the other didn’t. After one year, the GLP-1 group had a much lower death rate (0.37 % vs. 0.93 %) — hazard ratio ~0.14 — meaning about an 86 % relative reduction. They also had fewer major cardiovascular events (MACE: heart failure, MI, stroke) — 1.09 % vs. 2.19 %, HR ~0.60. The biggest driver was a reduction in heart failure events. The rates of myocardial infarction and stroke individually were not significantly different. The authors argue that GLP-1 agonists might help reduce death and heart disease risk in obese RA patients (even without diabetes), and suggest clinical trials should test this hypothesis.
In obese patients with rheumatoid arthritis who did not have diabetes, starting GLP-1 receptor agonists (such as semaglutide, liraglutide, or tirzepatide) was linked to lower death rates and fewer major heart problems compared with similar patients not on these drugs. After one year, the GLP-1 group had about an 86% lower risk of dying and a 40% lower risk of major cardiovascular events, mainly due to fewer cases of heart failure, while heart attack and stroke rates were not significantly different. These findings suggest GLP-1 drugs may offer protective heart and survival benefits in RA, but more research is needed to confirm.
