Carlucci Philip M, Cohen Brooke, Saxena Amit, Belmont H Michael, Masson Mala, Gold Heather T, Buyon Jill, Izmirly Peter
Department of Medicine, New York University School of Medicine, New York, NY, USA.
Rheumatology (Oxford). 2025 May 1;64(5):3085-3089. doi: 10.1093/rheumatology/keae547.
Glucagon-like peptide-1 receptor agonists (GLP1-RA) are an emerging class of medications with demonstrated promise in improving cardiometabolic outcomes. Whether these drugs may be useful in mitigating the cardiac risk associated with SLE remains unknown, and a recent case of drug-induced lupus secondary to GLP1-RA use calls the safety of GLP1-RAs in SLE patients into question. Accordingly, this retrospective analysis was initiated to evaluate outcomes of GLP1-RAs in SLE.
All patients in the NYU Lupus Cohort who had used a GLP1-RA were eligible for inclusion. Patient characteristics were assessed at baseline (most recent rheumatology visit prior to starting GLP1-RA), 1-4 months and 6-10 months after GLP1-RA initiation.
Of the 1211 patients in the cohort, only 24 had received a GLP1-RA. Six were excluded due to insufficient documentation regarding duration of medication use. Of the remaining 18 (median age 50), 17 (94%) were female and nine (50%) were White. There was one mild-to-moderate flare at 6-10 months, but no patients accumulated new SLE criteria during the follow-up period. Compared with baseline, median BMI was reduced by 3% at 1-4 months (P = 0.002) and 13% at 6-10 months (P = 0.001). Nine (50%) patients were initially denied insurance coverage for a GLP1-RA.
While limited by a small sample size, this descriptive study showed that GLP1-RAs did not trigger flares above expected background rates and were associated with significantly decreased BMI. Future studies exploring the potential benefits of GLP1-RAs in patients with SLE are warranted.
胰高血糖素样肽-1受体激动剂（GLP1-RA）是一类新兴药物，已证明在改善心脏代谢结局方面具有前景。这些药物是否有助于减轻与系统性红斑狼疮（SLE）相关的心脏风险尚不清楚，最近有一例因使用GLP1-RA继发药物性狼疮的病例，使GLP1-RA在SLE患者中的安全性受到质疑。因此，开展了这项回顾性分析以评估GLP1-RA在SLE中的结局。
纽约大学狼疮队列中所有使用过GLP1-RA的患者均符合纳入标准。在基线（开始使用GLP1-RA之前的最近一次风湿病就诊）、GLP1-RA起始后1 - 4个月和6 - 10个月评估患者特征。
在该队列的1211名患者中，只有24名接受过GLP1-RA。6名因用药持续时间记录不足而被排除。其余18名（中位年龄50岁）患者中，17名（94%）为女性，9名（50%）为白人。在6 - 10个月时有1例轻度至中度病情活动，但在随访期间没有患者累积新的SLE标准。与基线相比，1 - 4个月时中位体重指数（BMI）降低了3%（P = 0.002），6 - 10个月时降低了13%（P = 0.001）。9名（50%）患者最初被拒绝给予GLP1-RA的保险覆盖。
尽管受样本量小的限制，但这项描述性研究表明，GLP1-RA并未引发高于预期背景率的病情活动，且与BMI显著降低相关。有必要开展进一步研究探索GLP1-RA在SLE患者中的潜在益处。
