P073 GLP-1 agonists, weight-loss and systemic autoimmune rheumatic diseases: functional outcomes and real-world safety experience

Background/Aims Obesity is a significant co-morbidity in systemic autoimmune rheumatic diseases (SARDs), causing increased disease activity, reduced therapy effectiveness and increased cardiovascular risk. Glucagon-like peptide (GLP) agonists (semaglutide, liraglutide, tirzepatide), aid weight loss and reduce metabolic effects of obesity. There is paucity of data on GLP-1 agonist and impact in SARDs. We reviewed SARD patients receiving GLP injectables to evaluate functional outcomes, access, tolerability, and metabolic change. Methods We retrospectively reviewed 23 SARD patients (psoriatic arthritis, rheumatoid arthritis, SLE, Sjögren’s, myositis, vasculitis, undifferentiated CTD) treated with GLP-based injectables in 2024-2025. Collected data included demographics, indication, access route, treatment duration, BMI, modified HAQ (mHAQ), patient-reported SARD status, HbA1c, adverse events, and satisfaction. Wilcoxon rank tested paired mHAQ; Spearman assessed associations. Results The cohort (n = 23) had a mean age of 48.6 ± 10.1 years, 87% female, median disease duration 5 years (IQR 5), treatment duration 40 weeks (IQR 42). Mean mHAQ reduced by 0.31 ± 0.41 (p=0.002). Patient reported disease status improved in 39%, was stable in 56%, while 4% worsened. Indications for GLP-1 agonist use were weight reduction (48%), diabetes + weight (30%), steroid related gain (13%), and arthritis symptoms (9%). Access was mainly private (70%) vs NHS (30%). Among 18 patients with paired BMI data, mean %BMI change was −16.1 (SD 10.0; 95% CI − 21.1 to − 11.1), with 89% achieving ≥5% and 72% ≥10% loss. Greater BMI loss correlated with higher satisfaction (r = −0.54, p=0.024). Mean HbA1c decreased by 5.6 mmol/mol (n = 9) and triglycerides by 0.12 mmol/L (n = 8). AEs occurred in 61% (nausea, diarrhoea, headache), comparable to population rates; satisfaction remained high (8.4/10) and 78% would continue therapy. Conclusion In this real-world SARD cohort, incretin-based therapy was associated with functional improvement, patient-reported stability/improvement, and clinically meaningful weight loss, with good tolerability (similar AEs) and high satisfaction. Predominant private access (70%) highlights inequity within current NHS pathways. Despite limitations of retrospective design, small sample size, and incomplete biomarkers, findings support GLP-1 agonist therapy as an addition to immunosuppressive therapy for SARD patients promoting functional and quality-of-life improvement. Larger prospective multicentre studies are needed to confirm these results.