Glucagon‐Like Peptide‐1 Receptor Agonist Therapy Is Associated With Improvement in Psoriatic Arthritis–Related and Metabolic Outcomes: A Retrospective Analysis of Two Cohorts

OBJECTIVE: Obesity is highly prevalent in psoriatic arthritis (PsA) and is associated with worse disease outcomes. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly being used for weight loss and diabetes, but their impact on PsA outcomes remains unclear. We aimed to characterize patients with PsA initiating GLP-1RAs and assess longitudinal changes in weight, PsA activity, and cardiometabolic parameters. METHODS: We conducted a retrospective analysis of patients with PsA who initiated GLP-1RAs. PsA disease activity data and cardiometabolic parameters from clinical visits within one year before and after GLP-1RA initiation, along with demographics and comorbidities, were collected. RESULTS: Forty-eight patients with a median body mass index of 34.9 were included. Significant weight loss was observed posttreatment (-6.43 kg, 95% confidence interval [CI] -9.5 to -2.0; P < 0.0001), with 60% losing ≥5% of their baseline bodyweight. C-reactive protein levels (-1.1 mg/L; P = 0.002), pain scores (-1.0; P = 0.01), and triglyceride levels (-0.35 mmol/L; P = 0.02) decreased significantly. Each 1% reduction in body weight was associated with significant improvements in the Disease Activity in Psoriatic Arthritis score (β = -0.49, 95% CI -0.94 to -0.03), tender joint count (β = -0.18, 95% CI -0.32 to -0.05), EuroQol 5-domain (β = 0.0016, 95% CI 0.008-0.023), low-density lipoprotein cholesterol levels (β = -0.05, 95% CI -0.10 to -0.003), and systolic blood pressure (β = -0.67, 95% CI -1.18 to -0.15). CONCLUSION: In this real-world study, GLP-1RA therapy in PsA was associated with clinically meaningful weight loss and improvements in systemic inflammation, pain, and cardiometabolic markers. Improvements in psoriatic outcomes were proportional to the degree of weight loss. These findings warrant further investigation in prospective controlled studies to evaluate the role of GLP-1RAs in PsA management and comorbidities.