Effect of Glucagon‐Like Peptide 1 Receptor Agonists on Patients With Rheumatoid Arthritis

Objective Glucagon‐like peptide 1 receptor agonists (GLP‐1RAs) are approved for weight loss, diabetes, and cardiovascular risk reduction. Despite widespread use, GLP‐1RAs have not been well studied in patients with rheumatoid arthritis (RA). We examined the effects of GLP‐1RAs on RA disease activity and cardiovascular risk profile in patients with RA and overweight or obesity. Methods We conducted a retrospective chart review study of patients with RA with a body mass index of ≥27 who were prescribed a GLP‐1RA (semaglutide or tirzepatide). Between 2018 and 2024, 173 patients with RA were identified in the treatment group (prescribed and took a GLP‐1RA), and 42 patients with RA were identified in the control group (prescribed but did not take GLP‐1RA). Patients were assessed at three‐month intervals for up to one year after prescription. Outcome measures included RA disease activity, cardiovascular risk markers, and patient‐reported outcomes. Changes in outcome measures within and between groups were assessed with linear mixed effect models, with adjustments for baseline characteristics that differed significantly between groups. Results GLP‐1RA–treated patients experienced significantly greater reductions in RA disease activity, pain, body weight, total cholesterol, and glycosylated hemoglobin than controls ( P < 0.05). Within the treatment group, there were also significant reductions in erythrocyte sedimentation rate, C‐reactive protein values, low‐density lipoprotein cholesterol values, and triglyceride values ( P < 0.05). Nearly one‐third of the treatment group discontinued the GLP‐1RA during the study period, with the most common adverse effect being gastrointestinal issues. Conclusion This study suggests that the use of GLP‐1RAs can improve RA disease activity and cardiovascular risk profile. Although further research is needed, this novel finding has significant clinical implications because it suggests that anti‐obesity medications may improve both cardiovascular and RA outcomes.