medwireNews: People with fibromyalgia could benefit from treatment with glucagon-like peptide (GLP)-1 receptor agonists, suggests a large database analysis.
Use of GLP-1 receptor agonists was associated with a reduced symptom burden, particularly with regard to opioid dependency, fatigue, and pain, reported Nouran Eshak (Mayo Clinic Arizona, Scottsdale, USA) at the EULAR 2025 Congress.
She told the audience in Barcelona, Spain, that the idea for the research arose from her “doomscrolling” on TikTok, which led her to videos and comments from people taking GLP-1 receptor agonists who found improvements in inflammation and joint pain.
Eshak explained that the potential mechanisms by which these agents could affect pain include increasing interleukin-10 levels, increasing beta endorphins in the brain and spinal cord, and decreasing proinflammatory cytokines.
The researchers reviewed the TriNetX research network to identify 46,409 individuals with a diagnosis of fibromyalgia who had used GLP-1 receptor agonists on two or more separate occasions, and 716,185 patients with fibromyalgia but no documented use of GLP-1 receptor agonists.
After propensity score matching for baseline characteristics such as age, sex, comorbidities, glycated hemoglobin, BMI, and the use of medications, the final cohorts consisted of 38,439 patients each.
Over 5 years of follow-up, beginning 1 year after inclusion in the analysis, opioid use was reported in 47.3% of the GLP-1 receptor agonist group compared with 59.9% of the control group. This equated to an absolute risk difference of 12.6 percentage points and a significant odds ratio (OR) of 0.60 favoring GLP-1 receptor agonist use.
Pain and fatigue were similarly reported by significantly fewer people who did versus did not use GLP-1 receptor agonists, at rates of 34.1% versus 43.2%, and 21.8% versus 32.7%, respectively. The corresponding absolute between-group differences were –9.1 and –10.8 percentage points, while the ORs were 0.68 and 0.58.
Disability did not differ significantly between the groups, but the rates were “pretty low in both groups,” at an identical 0.1%, noted the presenter.
She also highlighted that although mean BMI was significantly higher in the GLP-1 receptor agonist than control cohort, at 35.3 versus 34.1 kg/m2, the baseline BMI for the former was 37.3 kg/m2, “so there has been a weight reduction.”
Discussing the findings, Eshak drew attention to the strengths of the study such as the use of real-world multicenter data and a large, matched cohort. But she also acknowledged the limitations, including the lack of fibromyalgia-specific validated outcomes measures or scales and the inability to account for confounders such as severity, duration of illness, and access to care.
Nevertheless, the investigator believes that “we have a signal or some sort of trend saying that GLP-1 receptor agonists can be helpful in managing fibromyalgia.”
Her recommendation is to consider using GLP-1 receptor agonists in fibromyalgia patients who have comorbidities – diabetes, obesity – for which these agents are already indicated.
“Finally, I do believe that we still need further studies, whether retrospective or prospective, […] with validated outcome measures,” concluded Eshak.
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