# GLP-1 Drugs and Rheumatoid Arthritis: One Study, and What It Cannot Tell You By Nora Bissett, Pricing Editor (https://glpwatchdog.org/authors/nora-bissett) | Published: 2026-08-21 | Updated: 2026-11-01 Canonical page: https://glpwatchdog.org/research/glp1-and-rheumatoid-arthritis > A retrospective review of 215 patients found greater falls in disease activity and pain among those who took a GLP-1 than among those prescribed one who did not. Nearly a third stopped the drug within the year. ## Key points - 173 patients with RA who took a GLP-1 against 42 who were prescribed one and did not; up to 12 months, assessed quarterly. - Greater reductions in disease activity, pain, weight, total cholesterol and HbA1c; ESR and CRP fell within the treated group. - Nearly one third of the treated group discontinued, most often for gastrointestinal side effects. - The study cannot separate a drug effect from a weight-loss effect, and there is no comparable evidence in lupus. In the only study to look, people with rheumatoid arthritis and a BMI of 27 or above who took a GLP-1 had greater reductions in disease activity and in pain than people who were prescribed one and did not take it. Inflammatory markers (ESR and CRP) fell within the treated group too.[1] It is a retrospective chart review of 215 people, it is the first of its kind, and nearly a third of the treated group stopped the drug before the year was out. ## What was measured Between 2018 and 2024, researchers identified 173 patients with rheumatoid arthritis and a BMI of at least 27 who were prescribed a GLP-1 (semaglutide or tirzepatide) and took it, and 42 who were prescribed one and did not. Everyone was assessed at three-month intervals for up to a year. Changes were modeled with linear mixed effects and adjusted for baseline characteristics that differed between the groups.[1] *Retrospective chart review, up to 12 months. All differences P < .05.[1]* | | Treated vs control | Within the treated group | | --- | --- | --- | | RA disease activity | greater reduction | — | | Pain | greater reduction | — | | Body weight | greater reduction | — | | Total cholesterol | greater reduction | — | | HbA1c | greater reduction | — | | ESR and CRP | — | significant reductions | | LDL cholesterol, triglycerides | — | significant reductions | The comparator is the unusual part, so understand it before reading anything into the result. The control group is not untreated patients; it is patients whose clinician made the same prescribing decision, who then did not take the drug. That removes one large source of bias, the decision to prescribe, and introduces another, because the reasons a person does not start a medication are rarely unrelated to how they are doing. > **Nearly one third of the treated group discontinued during the study period**, most commonly for gastrointestinal side effects.[1] The analysis kept every treated patient regardless of how long they took the drug, so the treated group’s results blend people who stayed on it with people who stopped partway through the year.[1] ## Why weight loss alone does not settle it The obvious explanation is that losing weight reduces mechanical load on joints and lowers systemic inflammation, and that the GLP-1 is incidental to both. That would still be a useful finding for someone with rheumatoid arthritis carrying excess weight. But it would mean the drug is doing nothing to the disease that any weight loss would not do, and this study cannot separate the two. The falls in ESR and CRP are consistent with either reading. [Inflammatory markers respond to weight loss](https://glpwatchdog.org/research/tirzepatide-and-inflammation). They also respond to disease-modifying therapy, which everyone in the study was presumably continuing. Nothing here supports substituting a GLP-1 for a DMARD, and nobody has studied that. ## And lupus, where the records are new Lupus is routinely bracketed with rheumatoid arthritis in coverage of this question, but it has its own records, and they mostly ask something else. In a 2026 US study of 1,914 people with lupus and type 2 diabetes, those who started a GLP-1 had fewer major heart events (hazard ratio 0.66) and less kidney decline (0.77) than those who started a DPP-4 inhibitor.[2] A second records study, of 9,386 people, found less lupus nephritis at one year (relative risk 0.59) and fewer recorded flares.[3] Disease activity itself has barely been measured: a New York lupus cohort followed 18 patients and recorded one flare,[4] and a 2026 scoping review identified no randomized trials.[5] If you have lupus, these are heart and kidney findings from people with diabetes, no trial has tested the drugs in your condition, and a general claim about “autoimmune disease” is not a substitute for a study in your condition. ## What to take from it - This is one retrospective chart review of 215 people. It is a reason for a proper trial, not a reason to expect a joint benefit. - No GLP-1 is approved for rheumatoid arthritis, and none of this displaces disease-modifying therapy. - The improvement may be weight loss rather than anything specific to the drug. The study cannot tell the difference. - Gastrointestinal side effects drove a substantial share of people off the drug within a year, in a population already managing a chronic illness. - Methotrexate, biologics and other DMARDs interact with a great deal. Adding any drug is a conversation with your rheumatologist. For a different inflammatory condition where a randomized trial does exist, see [a biologic plus tirzepatide for psoriasis](https://glpwatchdog.org/research/a-biologic-plus-tirzepatide-for-psoriasis). For what these drugs do to joints through weight alone, see [GLP-1s and knee osteoarthritis](https://glpwatchdog.org/research/glp1-knee-osteoarthritis). ## Frequently asked questions ### Do GLP-1 drugs help rheumatoid arthritis? One retrospective chart review of 215 patients found greater reductions in disease activity and pain among those who took a GLP-1 compared with those prescribed one who did not take it. It is the only study of its kind, it is not randomized, and no GLP-1 is approved for rheumatoid arthritis. ### Is the benefit just from losing weight? Possibly, and the study cannot separate the two. Weight loss reduces mechanical joint load and lowers inflammatory markers on its own. The falls in ESR and CRP are consistent with either explanation. ### What about lupus? Records studies of people with lupus and type 2 diabetes report fewer heart events, less kidney decline and less lupus nephritis on a GLP-1 than on comparison drugs. No randomized trial has tested these drugs in lupus, and direct evidence on flares is thin, so none of this shows they treat the disease. ### How many people stayed on the drug? Nearly one third of the treated group discontinued during the study period, most commonly because of gastrointestinal side effects. That matters when reading the results, because the analysis kept everyone in the treated group regardless of how long they took the drug, so its averages include people who stopped partway through the year. ## References 1. Kellner DA, Dente E, Tran V, et al. Effect of Glucagon-Like Peptide 1 Receptor Agonists on Patients With Rheumatoid Arthritis. ACR Open Rheumatology. 2025. PMID: 40932015. https://pubmed.ncbi.nlm.nih.gov/40932015/ 2. Jorge A, Patel AV, Zhou B, et al. Glucagon-Like Peptide-1 Receptor Agonist Use and the Risk of Adverse Cardiac and Kidney Outcomes Among Patients With Systemic Lupus Erythematosus and Lupus Nephritis. Arthritis & Rheumatology. 2026. PMID: 40994310. DOI: 10.1002/art.43403. https://pubmed.ncbi.nlm.nih.gov/40994310/ 3. Hanif M, Nagarajan JS, Murphy R, et al. Glucagon-like peptide-1 receptor agonist and lupus nephritis in systemic lupus erythematosus with type 2 diabetes. American Journal of Medicine. 2026. PMID: 41812723. DOI: 10.1016/j.amjmed.2026.02.016. https://pubmed.ncbi.nlm.nih.gov/41812723/ 4. Carlucci PM, Cohen B, Saxena A, et al. A retrospective evaluation of glucagon-like peptide-1 receptor agonists in systemic lupus erythematosus patients. Rheumatology. 2025. PMID: 39388251. DOI: 10.1093/rheumatology/keae547. https://pubmed.ncbi.nlm.nih.gov/39388251/ 5. Sia R, Ting EL, Choy SW, Oon S. GLP-1 receptor agonists in systemic lupus erythematosus: a scoping review. RMD Open. 2026. PMID: 42463280. DOI: 10.1136/rmdopen-2026-007037. https://pubmed.ncbi.nlm.nih.gov/42463280/ --- Cite as: GLP Watchdog, Nora Bissett, "GLP-1 Drugs and Rheumatoid Arthritis: One Study, and What It Cannot Tell You", published 2026-08-21, updated 2026-11-01. https://glpwatchdog.org/research/glp1-and-rheumatoid-arthritis Canonical HTML page: https://glpwatchdog.org/research/glp1-and-rheumatoid-arthritis Medical disclaimer: Nothing here is medical advice. We report on this subject; we do not treat anyone. Whether to begin a medication, supplement, or treatment, whether to adjust it, and whether to stop are questions for a clinician licensed to answer them, who knows your history.