Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) initially approved for type 2 diabetes management have been increasingly used as weight loss treatments.
As weight loss may improve RMD outcomes, researchers evaluated GLP-1 RA use patterns and effects among this patient population.
Across both GLP-1 RAs, non-diabetic users lost more weight than diabetic users, with [tirzepatide] showing greater reductions than [semaglutide] over time.
Multivariable linear regression was used to assess 12-month weight loss by GLP-1 type, adjusted for baseline weight, age, sex, and diabetes.
“Across both GLP-1 RAs, non-diabetic users lost more weight than diabetic users, with [tirzepatide] showing greater reductions than [semaglutide] over time,” the study authors concluded.
Semaglutide and tirzepatide are effective for achieving weight loss among patients with rheumatic and musculoskeletal diseases (RMDs) with and without diabetes, with treatment patterns showing rising uptake, according to study results presented at the European Alliance of Associations for Rheumatology (EULAR) Congress 2026, held from June 3 to 6 in London, England.
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) initially approved for type 2 diabetes management have been increasingly used as weight loss treatments. As weight loss may improve RMD outcomes, researchers evaluated GLP-1 RA use patterns and effects among this patient population.
A retrospective analysis was conducted using Q3 2024 data from the American College of Rheumatology Rheumatology Informatics System for Effectiveness registry; patients with RMDs who received semaglutide or tirzepatide between January 2005 and September 2024 were included. Patients were categorized as new users (≥1 evaluation and management visit before GLP-1 initiation) or prevalent users (no prior evaluation and management visit).
Across both GLP-1 RAs, non-diabetic users lost more weight than diabetic users, with [tirzepatide] showing greater reductions than [semaglutide] over time.
The researchers examined baseline characteristics, RMD diagnoses, concurrent medications, and weight changes at 6, 12, and 18 months, stratified by GLP-1 type and diabetes status. Multivariable linear regression was used to assess 12-month weight loss by GLP-1 type, adjusted for baseline weight, age, sex, and diabetes.
Among the 60,206 patients included in the analysis, 67% had diabetes and 70% used semaglutide. Uptake was highest among patients with rheumatoid arthritis (20.7%) and osteoarthritis (12.8%), with the most rapid increase occurring in 2023 and accounting for 32% and 41% of all semaglutide and tirzepatide use, respectively.
Weight trajectories were assessed among 40,006 new users of semaglutide or tirzepatide, with similar baseline patient-reported outcomes across GLP-1 RA types. However, users with vs without diabetes had higher mean (SD) RAPID-3 scores (11.6 [SD, 6.6] vs 10.7 [SD, 6.3]) and Multidimensional Health Assessment Questionnaire scores (4.7 [SD, 2.9] vs 4.4 [SD, 2.8]), indicating greater disease burden.
At 12 months, users without diabetes who received tirzepatide lost 8.0% (SD, 11.3) of body weight compared with 6.0% (SD, 9.2) among those who received semaglutide; users with diabetes showed a similar pattern, with tirzepatide consistently outperforming semaglutide.
In adjusted models, tirzepatide users lost approximately 1.7% (P <.001) more weight at 12 months than semaglutide users, and patients without diabetes lost approximately 1.5% (P <.001) more weight than those with diabetes, independent of GLP-1 RA type.
“Across both GLP-1 RAs, non-diabetic users lost more weight than diabetic users, with [tirzepatide] showing greater reductions than [semaglutide] over time,” the study authors concluded.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
