Diabetes, weight loss drugs emerging as treatment pathway in rheumatology
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Drugs used to treat diabetes and obesity, such as GLP-1 receptor agonists, are becoming an important treatment pathway in rheumatology, according to a presenter at the 2024 Association of Women in Rheumatology annual conference.
“We will need to know more about these drugs,” Janet E. Pope, MD, MPH, FRCPC, professor of medicine at the University of Western Ontario, in London, Canada, told attendees. “They’re here to stay and a good way to help our patients, as well as others.”
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Describing both drug classes as being “really in” at the moment, Pope outlined the benefits that GLP-1 agonists and SGLT-2 inhibitors may present to rheumatology patients. She highlighted a Canadian study finding that patients with diabetes and autoimmune diseases treated with GLP-1 receptor agonists demonstrated fewer major adverse cardiovascular events (MACE) and lower mortality.
“You can say, ‘Yes, but that’s already been shown in diabetes, so is it added value for our patients with autoimmune diseases?’” Pope said. “I think the easy answer is yes, probably. More and more research is coming out saying that if you’re a non-diabetic and the GLP-1 receptor agonists are used, you are going to see a benefit in these autoimmune diseases — certain diseases for certain things.”
Pope additionally discussed research indicating that SGLT2 inhibitors reduce MACE and adverse renal outcomes among people with lupus and type 2 diabetes.
“Can it happen in lupus alone? The answer is probably yes,” she said. “Although trials should be done in SLE, there’s good substantiation that this will decrease proteinuria in our lupus nephritis patients.”
However, Pope added that while it is important to be aware of these drugs, rheumatologists may not necessarily be the clinicians who ultimately prescribe them.
“Probably many of you are seeing your nephrologists co-prescribing if you have a patient with renal lupus with proteinuria,” she said. “It’s an emerging pathway for us that’s very established in other diseases.”
Meanwhile, statins may also bring marginal benefits to some rheumatology patients, according to Pope.
“Statins both decrease the onset of rheumatoid arthritis and can treat RA just a little bit,” she said. “If the patient needs a statin, you can always say, ‘Oh, and it may help your joints a little bit.’ So say several RCTs.”
Metformin has also shown incremental benefits in both RA and psoriatic arthritis, Pope added.
“Because our patients have so much comorbidity, it’s good to know that if metformin is added, you can tell your patients it might help their inflammatory arthritis a little bit as well,” she said.
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Pope J. Emerging Pathways in Rheumatology. Presented at: Association of Women in Rheumatology annual conference; July 25-27, 2024; Orlando, Florida (hybrid meeting).
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