Ozempic and Wegovy: Improves Rheumatoid Arthritis Symptoms

Positive Reports from RA Patients

A growing number of people with rheumatoid arthritis (RA) are reporting that GLP-1 drugs like Ozempic, Wegovy, and Zepbound are helping them better manage symptoms and decrease flare-ups.

Connection Between Obesity and RA

Some people report that GLP-1 anti-obesity medications like Wegovy have helped improve their rheumatoid arthritis. Body fat and higher BMIs have been associated with a higher risk of developing rheumatoid arthritis. Health experts say more research is needed to understand the connection.

Beyond Weight Loss Benefits

The weight-loss benefits of GLP-1 medications like Ozempic, Wegovy, and Zepbound are widely known. However, as more people take these medications, there appear to be other benefits, such as reducing the risk of heart disease, stroke, kidney disease, and colon cancer. Recently, anecdotal accounts have surfaced of GLP-1 medications also helping people with rheumatoid arthritis (RA) manage their pain and experience a decrease in flare-ups.

Expert Insights on GLP-1 and RA

Impact on Autoimmune Patients

“It is well established that autoimmune patients with obesity fare worse than those without. [They] have higher symptoms and less response to traditional therapies,” Dr. Elizabeth Ortiz, rheumatologist and clinical advisor at WellTheory, told Healthline. “I have seen patients lose weight and then require less immunosuppressant therapy for their condition.”

Systematic Review Findings

According to a systematic review and meta-analysis of cohort studies, there is a positive association between levels of body fat and the risk of developing RA. Additionally, higher BMI (in middle age and early adulthood) and waist circumference are associated with a higher risk of RA. Obesity has been linked to worse autoimmune and inflammatory symptoms and less favorable responses to standard therapy for RA.

Holistic Care Approach

“In addition to keeping autoimmune patients from feeling their best in the short term, the combination of obesity and autoimmunity can have a major impact on health in the long term,” Ortiz said. “Those with rheumatoid arthritis and other autoimmune diseases carry a higher risk of cardiovascular disease than those without these conditions. Our best defense against this is tight control of autoimmune inflammation and all other cardiovascular disease risk factors, such as obesity.”

Emerging “Obesity First” Approach

Potential Benefits

Dr. Fatima Cody Stanford, associate professor of medicine and pediatrics at Harvard Medical School, said reducing weight can lead to less joint pain and inflammation, improved mobility, and reduced disease activity. “Moreover, weight loss can improve overall health, reduce comorbidities such as cardiovascular disease and diabetes, and enhance the effectiveness of RA medications,” Stanford told Healthline.

Holistic Strategy

Treating obesity first to help with other conditions has been coined the “obesity first” approach. Stanford said it is an emerging and promising strategy because addressing obesity directly can have a broad range of positive effects on multiple chronic conditions. “By targeting obesity first, healthcare providers can potentially improve or even resolve associated conditions like type 2 diabetes, hypertension, and dyslipidemia,” she said. “This holistic approach recognizes obesity as a root cause rather than a consequence, aiming to improve overall patient health and simultaneously reduce the burden of multiple chronic diseases.”

Caution Against Solely Focusing on Obesity

However, Ortiz believes it is too early to take an “obesity first” approach for autoimmune disease. While a proportion of patients with autoimmunity may have positive results by solely focusing on obesity, she said this will not be the case for everyone. “The biologic triggers for any particular individual’s autoimmune disease are complex and personal, and taking an ‘obesity first’ approach without also addressing the underlying autoimmune disease may expose patients to unnecessary risk from poorly controlled inflammation,” she said.

Future of GLP-1 Drugs in RA Treatment

Need for Collaborative Treatment Plans

As the complex relationships between obesity, metabolic health, and chronic diseases deepen, Stanford said collaboration between obesity medicine physicians, endocrinologists, rheumatologists, cardiologists, and primary care providers is needed to create comprehensive treatment plans that address the root causes of these conditions. “As new therapies and strategies emerge, they offer hope for improved quality of life and outcomes for patients struggling with obesity and associated chronic diseases,” she said. “Continued research and innovation will be key in advancing these efforts and providing evidence-based care.”

Exploring Anti-Inflammatory Properties

Given the anti-inflammatory properties that GLP-1 drugs provide and their effects on the immune system, Stanford said these medications could be promising in the context of autoimmune diseases. She anticipates more research regarding their potential benefits. “Preliminary research has suggested that GLP-1s may modulate immune responses and reduce inflammation, which could benefit conditions like RA, systemic lupus erythematosus (SLE), and inflammatory bowel disease (IBD),” said Stanford. “Further research is needed to understand the mechanisms involved and to evaluate their efficacy and safety in these contexts.”

Addressing Key Questions

Ortiz agreed. She said those treating autoimmune diseases don’t want to turn to GLP-1 drugs without a better understanding of how and why autoimmune patients may benefit from them. For instance, key questions that need to be answered include:

  • What are the anti-inflammatory effects of GLP-1s, and how do they impact those with autoimmune disease?
  • What type of autoimmune disease patient would benefit from this type of treatment, and what kind of effect can be expected?
  • What is the effect of these medications on the microbiome, and how does that impact autoimmune disease?
  • How much weight loss (if any) is needed to see an impact?
  • Are the benefits of GLP-1s in RA patients solely from weight loss?

Balancing Benefits and Risks

Understanding the effects of GLP-1 drugs on a person with an autoimmune disease like RA who is not overweight or obese needs further research. “As we continue to discover [GLP-1s] biologic effects on inflammation and our immune systems and continue to accrue data in people using them for obesity and diabetes, we may find they are a useful tool against autoimmunity, aside from their impact on obesity,” said Ortiz. Any positive impact would have to be weighed against potential risks of using these medications, such as the risk of muscle loss, as muscle loss can lead to osteoporosis, a condition often associated with autoimmune diseases, she noted.

Conclusion

Overall, more time is needed to determine whether or not GLP-1 drugs can be used to control autoimmunity and inflammation in those with or without obesity and how best to utilize the medications for these purposes. “What is likely to be addressed more quickly is how these medications can be utilized as a supplement to standard autoimmune therapy to improve metabolic syndrome and decrease an autoimmune patient’s cardiovascular risk,” said Ortiz.