Cardiovascular diseases are the leading cause of premature death in many autoimmune rheumatic diseases (ARDs). Landmark randomized controlled trials in diabetes and obesity have demonstrated that glucagon-like peptide-1 receptor agonists (GLP-1RAs) have cardiovascular-kidney-metabolic benefits. Observational studies assessing GLP-1RAs in ARDs, including rheumatoid arthritis and systemic lupus erythematosus, have found reductions in risk of cardiovascular events similar to those reported in broader populations. GLP-1RAs likely exert their cardioprotective effects through direct and indirect mechanisms. GLP-1RAs treat type 2 diabetes and obesity, two important cardiovascular risk factors. They lower lipid levels by mitigating post-prandial hyperlipidaemia and reduce blood pressure by dampening carotid body-mediated sympathetic excitation. GLP-1RAs have anti-atherogenic and anti-inflammatory effects in mice. They attenuate T cell-mediated inflammation directly by activating GLP-1 receptors on gut intraepithelial lymphocytes, and myeloid cell-mediated inflammation indirectly by activating central neuronal GLP-1 receptors. While knowledge gaps remain, existing evidence supports a cardioprotective role for GLP-1RAs in ARDs.
Karacabeyli et al. (2026) studied this question.