A retrospective evaluation of glucagon-like peptide-1 receptor agonists in systemic lupus erythematosus patients.

OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.