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Purpose of Review <p>Obesity is associated with elevated cardiovascular risk, greater pain, and higher disease activity/severity in several rheumatic diseases. Intentional weight loss through dietary or surgical interventions has been shown to improve pain and disease control in common arthritides like osteoarthritis (OA), rheumatoid arthritis (RA), and psoriatic arthritis. In this review, we summarize FDA-approved and off-label medications for weight loss, highlighting practical considerations and potential pleiotropic benefits for people with rheumatic diseases.</p> Recent Findings <p>Preclinical studies suggest immunomodulatory, chondroprotective, and analgesic properties of both glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and metformin, highlighting potential for these agents in rheumatology. Randomized controlled trials (RCTs) and large cohort studies have found that GLP-1 RAs and metformin improve pain in OA and may prevent progression to joint replacement. Large population-based cohort studies and secondary analyses of RCTs suggest that sodium-glucose cotransporter-2 inhibitors (SGLT2is) likely lower risk of gout attacks. While limited, emerging clinical data on GLP-1 RAs, metformin, and SGLT2is in other rheumatic diseases are promising.</p> Summary <p>Medications that facilitate weight loss may benefit people with rheumatic diseases and excess adiposity through various mechanisms. Further clinical research is needed. Carefully reviewing a patient’s history is crucial to ensure appropriate medication selection to maximize potential benefit and minimize risk.</p>

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Effects of Weight-lowering Medications in People With Obesity and Rheumatic Diseases

  • 期刊论文

  • 发表日期：

    2025年9月1日

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  • Derin Karacabeyli,
  • Diane Lacaille

摘要

Purpose of Review

Obesity is associated with elevated cardiovascular risk, greater pain, and higher disease activity/severity in several rheumatic diseases. Intentional weight loss through dietary or surgical interventions has been shown to improve pain and disease control in common arthritides like osteoarthritis (OA), rheumatoid arthritis (RA), and psoriatic arthritis. In this review, we summarize FDA-approved and off-label medications for weight loss, highlighting practical considerations and potential pleiotropic benefits for people with rheumatic diseases.

Recent Findings

Preclinical studies suggest immunomodulatory, chondroprotective, and analgesic properties of both glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and metformin, highlighting potential for these agents in rheumatology. Randomized controlled trials (RCTs) and large cohort studies have found that GLP-1 RAs and metformin improve pain in OA and may prevent progression to joint replacement. Large population-based cohort studies and secondary analyses of RCTs suggest that sodium-glucose cotransporter-2 inhibitors (SGLT2is) likely lower risk of gout attacks. While limited, emerging clinical data on GLP-1 RAs, metformin, and SGLT2is in other rheumatic diseases are promising.

Summary

Medications that facilitate weight loss may benefit people with rheumatic diseases and excess adiposity through various mechanisms. Further clinical research is needed. Carefully reviewing a patient’s history is crucial to ensure appropriate medication selection to maximize potential benefit and minimize risk.