The blockbuster weight-loss drugs are moving beyond obesity and diabetes, with emerging evidence pointing to a potentially important role in rheumatic disease. See what the experts think in this new Rheumatology Republic podcast.
GLP-1 receptor agonists have transformed the treatment of obesity and diabetes. Now rheumatologists may need to start paying much closer attention.
In this first episode of The Joint Review, hosts Dr Julian Segan and Professor Stephen Hall are joined by Melbourne rheumatologist – and competitive powerlifter – Dr Shom Bhattacharjee to unpack what these drugs could mean for rheumatology.
And the possibilities extend well beyond weight loss.
The trio takes a close look at a trial that tested semaglutide in people with obesity and knee osteoarthritis. Those receiving semaglutide lost about 14% of their body weight and recorded substantially greater improvements in WOMAC pain scores than the placebo group.
But is taking pressure off the knees the whole story?
Dr Bhattacharjee points out that adipose tissue is metabolically active and produces inflammatory mediators, raising the tantalising possibility that reducing visceral fat could affect osteoarthritis through inflammatory as well as mechanical pathways.
There are intriguing signals elsewhere, too. The rheumatologists discuss early results from a trial in psoriatic arthritis, which tested tirzepatide alongside ixekizumab and reported greater weight loss and improved ACR50 responses with the combination. They also consider where GLP-1 therapies might eventually fit in gout.
But there is no free lunch – as the hosts put it.
Related
Gastrointestinal adverse effects, loss of muscle mass, cost, and lingering questions over long-term safety all complicate the picture. For patients losing substantial amounts of weight, resistance training, and adequate protein intake may also become an important part of management.
GLP-1s may not yet be standard rheumatology fare, but the evidence is accumulating fast.
As Professor Hall aptly puts it: “We’ve got a new toy. We’re going to learn how to play with it.”
The Joint Review is produced in partnership with Melbourne rheumatologists Dr Julian Segan and Professor Stephen Hall and Rheumatology Republic. See here for more information about the story behind the podcast.
Rheumatology Republic is also interested in hearing from anyone else looking for a platform to launch a rheumatology podcast in Australia – please contact david@medicalrepublic.com.au.
