The use of glucagon-like peptide-1 (GLP-1)-based therapies was associated with increased joint pain and receipt of short-course corticosteroids among patients with rheumatoid arthritis (RA), according to study findings presented at the American College of Rheumatology (ACR) Convergence 2026, held November 6-11, 2026, in Orlando, Florida.

Given that obesity has been shown to exacerbate systemic inflammation and disease activity in RA, researchers evaluated whether GLP-1-based therapies could potentially improve clinical outcomes in this population. Using the TriNetX database, they identified patients aged 18 years and older with RA who had received a prescription for a GLP-1 medication (ie, semaglutide, liraglutide, or tirzepatide) within 6 months of diagnosis (n=2623) and those who had not on received a GLP-1 agent (n=219,262).

Cohorts were 1:1 propensity score matched (n=2622 per group) for baseline demographic characteristics and clinical comorbidities. The researchers assessed 1-, 2-, and 3-year risks of synovitis, joint stiffness, joint effusion, joint pain, prescription of short-course corticosteroids, and anemia.

The mean patient age was 55 years; 86.2% were female, 68.5% were White, and 7.9% were Hispanic or Latino. Findings showed the 1-year risk of joint pain was significantly increased in GLP-1 users compared with nonusers (risk ratio [RR], 1.29 [95% CI, 1.09-1.52]; P =.003). This increased risk persisted into year 2 (RR, 1.29 [95% CI, 1.11-1.50]; P =.001), at which point the risk of requiring short-course steroids was also significantly increased (RR, 1.08 [95% CI, 1.02-1.14]; P =.007).

At 3 years of follow-up, GLP-1 users were found to be at an increased risk for joint effusion (RR, 1.24 [95% CI, 1.01-1.52]; P =.038) and prescription of short-course corticosteroids (RR, 1.07 [95% CI, 1.01-1.14]; P =.022). No significant differences were observed between groups with regard to the incidence of joint stiffness, synovitis, or anemia.

Based on these findings, the authors concluded that RA patients prescribed GLP-1 based therapies “had inconsistent differences in RA flare-related outcomes across follow-up periods,” when compared with those not exposed to GLP-1 medications.