August 2026

RHEUMATOLOGY

Q&A: WHAT RHEUMATOLOGISTS SHOULD KNOW ABOUT GLP-1RAS IN LUPUS

GLP-1 receptor agonists (GLP-1RAs) may help address metabolic and cardiovascular risk in some patients with lupus, but current lupus-specific evidence is observational and not practice-changing yet.

Rosalind Ramsey-Goldman, MD, DrPH, shares her expert insights on what rheumatologists should know about these medications when it comes to lupus. 

Why are these generating interest in lupus research?
GLP-1RAs have been shown to reduce inflammation and blood pressure and improve cardiovascular outcomes in people with diabetes while improving metabolic health. These effects may be particularly relevant for patients with lupus, who experience elevated rates of cardiovascular disease and lupus nephritis.

What safety and drug considerations should rheumatologists keep in mind?
Because more serious complications can include kidney injury, severe GI reactions and gallbladder disease, careful monitoring is important, particularly in patients with active organ involvement or complex medication regimens.

Because GLP-1RAs delay gastric emptying, they can affect the absorption of certain medications. Rheumatologists should also consider the potential impact on glucose control when GLP-1RAs are used alongside therapies such as glucocorticoids or hydroxychloroquine.

What does the current evidence show in lupus?
In patients with lupus using GLP-1RAs, emerging observational studies have reported lower rates of:
  • Cardiovascular events
  • Kidney disease progression
  • Thrombosis
  • Mortality

Other preliminary studies have suggested a lower risk of lupus nephritis, a lower risk of flare and reductions in inflammatory markers.
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What are key unanswered questions?
Can GLP-1RAs directly influence lupus disease activity? Improve long-term outcomes? Is there a role for them to play alongside existing lupus therapies?
Rosalind Ramsey-Goldman, MD, DrPH, John P. Gallagher Research Professor of Rheumatology at Northwestern Medicine  

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