Association of GLP-1 Agonist Prescription with Improved Joint Outcomes in Rheumatoid Arthritis

Abstract:ObjectivesThe objective of this study is to quantify the relationship between glucagon-like peptide-1 (GLP-1) receptor agonist use and rheumatoid arthritis (RA) symptoms. MethodsThe TriNetX Database was queried to identify RA patients aged 18 or older. Two subgroups were formed: those with semaglutide, liraglutide, or tirzepatide prescription (n=9,680) and those without GLP-1 receptor agonist prescription (n=219,262). Groups were 1:1 propensity score matched (n = 9,599) for demographics and comorbidities. 90-day, 1-year, 2-year, and 3-year risks of synovitis, stiffness of joints, effusion of joints, pain in joints, prescription of short burst steroid, and anemia were assessed. Relative risk Ratios (RR) were calculated.ResultsThe study population consisted of 83.4% female, 67.4% white, 11.0% Latino, and a mean age of 59 years. GLP-1 agonist users had a significantly lower 90-day risk of prescription of short burst steroid (RR=0.87; p<0.001) and anemia (RR=0.61; p<0.001). This persisted at 1 year, with a decreased risk of prescription of short burst steroid (RR=0.92; p<0.001), anemia (RR=0.70; p<0.001), and effusion of joints (RR=0.83; p=0.004). At 2 years, there was a significantly lower risk of synovitis (RR=0.87; p=0.012), prescription of short burst steroid (RR=0.91; p<0.001), anemia (RR=0.69; p<0.001), and effusion of joints (RR=0.83; p<0.001). Lastly, GLP-1 agonist users had a significantly lower 3-year risk of synovitis (RR=0.80; p<0.001), pain in joints (RR=0.90; p=0.008), effusion of joints (RR=0.78; p<0.001), prescription of short burst steroid (RR=0.89; p<0.001), and anemia (RR=0.67; p<0.001).ConclusionOur observational study shows that RA patients with a GLP-1 agonist prescription were at lower risk for flare-up symptoms such as synovitis, stiffness, effusion of joints, and pain of joints compared to those without, and were found to have lower risk of short burst steroid prescription and anemia