If you’re living with lupus, you already know how challenging it can be to manage the ups and downs of this autoimmune condition. Fatigue, joint pain, and flare-ups are just a few of the common challenges. On top of that, if you also have diabetes or are trying to manage your weight, keeping your health in balance can feel even more complicated. Recently, glucagon-like peptide 1 (GLP-1) receptor agonists — drugs typically used to manage diabetes and support weight loss — have gained attention for their potential effects on inflammatory conditions. But can these medications help or harm people with lupus?

In this article, we’ll explore what GLP-1 drugs are, how they work, and whether they are a safe or effective option for people with lupus.

What Are GLP-1 Drugs?

GLP-1 receptor agonists are a class of medications primarily used to treat type 2 diabetes. These drugs work by mimicking the body’s natural glucagon-like peptide 1, a hormone that helps regulate blood glucose (blood sugar) by encouraging the pancreas to release insulin and reducing the amount of sugar your liver produces. These drugs also slow the movement of food through the digestive system, promoting a feeling of fullness that can aid in weight loss.

GLP-1 drugs include:

• Dulaglutide (Trulicity)
• liraglutide (Saxenda)
• Semaglutide (Ozempic, Wegovy, Rybelsus)

While GLP-1 drugs are primarily prescribed for managing diabetes, they have become increasingly popular for their effectiveness in supporting weight loss. But for people with lupus, the big question is whether these medications are safe and whether they might offer additional benefits or risks.

Why Might Someone With Lupus Consider GLP-1 Drugs?

Lupus, like many autoimmune diseases, often comes with other health issues. For example, people with lupus have a higher risk of developing conditions like type 2 diabetes and metabolic syndrome, both of which can make managing the disease more difficult. Additionally, medications used to treat lupus, like corticosteroids, can contribute to weight gain. As a result, some doctors may recommend GLP-1 drugs to help manage both blood sugar levels and weight in people with lupus.

Here are a few reasons why someone with lupus might consider GLP-1 medications:

Blood Sugar Control

Many people with lupus are also at risk for type 2 diabetes, either because of the disease itself or due to long-term use of medications like steroids. GLP-1 drugs help manage blood sugar levels, which can be crucial for someone with both lupus and diabetes.

Weight Loss

Weight gain is common in people with lupus, whether due to the disease, limited physical activity during flare-ups, or side effects of medications. GLP-1 drugs, particularly semaglutide, have been shown to support weight loss, which might improve overall health and potentially reduce the burden of lupus symptoms.

However, using GLP-1 drugs when you have lupus isn’t without potential concerns. There are specific safety issues that should be considered carefully, especially regarding interactions with lupus treatments and the risk of side effects.

Are GLP-1s Safe for People With Lupus?

There is still limited research on the direct effects of GLP-1 drugs on people with lupus. Most studies focus on diabetes or weight loss, but some concerns have been raised about their use in people with autoimmune conditions. A case report from March 2023 suggested a potential link between semaglutide and drug-induced lupus (DIL). While DIL is rare, it’s essential to consider this risk when evaluating whether GLP-1 drugs are the right choice for someone with lupus.

Here is a breakdown of the main safety concerns around GLP-1 drugs for people with lupus.

Drug-Induced Lupus

The 2023 case report noted the occurrence of drug-induced lupus in an individual on semaglutide. Drug-induced lupus can occur as a side effect of certain medications, leading to symptoms similar to systemic lupus erythematosus (SLE, the most common form of lupus), including joint pain, fever, and fatigue. While the condition usually goes away once the medication is stopped, it’s a significant concern for people already living with lupus. It’s important to discuss the potential risk with your doctor, especially if you’re considering semaglutide.

Inflammatory and Immune System Effects

Lupus is an autoimmune disease, meaning the immune system attacks the body’s own tissues, causing inflammation. GLP-1 drugs do not directly target inflammation, but they may have some effects on the immune system that could either be beneficial or harmful. More research is needed to understand the full impact of these drugs on autoimmune diseases like lupus.

Drug Interactions

If you’re already taking medications for lupus, such as immunosuppressants like methotrexate or biologics, it’s crucial to ask your health care provider whether adding a GLP-1 drug is safe. Immunosuppressants work by lowering the activity of the immune system, and while there is no strong evidence that GLP-1 drugs interfere with these treatments, potential interactions should always be evaluated on a case-by-case basis.

Side Effects

Common side effects of GLP-1 drugs include:

• Nausea
• Vomiting
• Diarrhea
• Pancreatitis, in some cases

People with lupus, who may already deal with chronic symptoms like fatigue and pain, might find these additional side effects difficult to manage. Moreover, medications affecting the digestive system could exacerbate gastrointestinal symptoms in people with lupus, who may already be predisposed to such issues​.

Possible Benefits of GLP-1 Drugs for People With Lupus

While the safety of GLP-1 drugs in people with lupus is still under study, there are several potential benefits that could make them an appealing option for those with coexisting conditions, such as diabetes or obesity.

Improved Blood Sugar Control

For people with both lupus and type 2 diabetes, managing blood sugar is essential. Poor blood sugar control can lead to additional complications, including cardiovascular disease, for which people with lupus are already at higher risk. GLP-1 drugs can help stabilize blood sugar levels, which may reduce the risk of complications associated with diabetes.

Weight Loss and Reduced Inflammation

Weight loss is another potential benefit, as obesity can heighten inflammation in the body, possibly worsening lupus symptoms. Losing weight with the help of GLP-1 drugs might help reduce inflammation and improve overall health. Some studies suggest that GLP-1 drugs may have mild anti-inflammatory properties, which could benefit those with inflammatory conditions like lupus, though further research is required​.

Better Cardiovascular Health

People with lupus are at an increased risk of heart disease. GLP-1 drugs have been shown to have cardiovascular benefits, such as a reduced risk of heart attacks and strokes in people with type 2 diabetes. For people with lupus, this added benefit could be an important consideration, particularly if they have other risk factors for heart disease.

Talk to Your Doctor

If you have lupus and are considering a GLP-1 drug, the most important step is to be open with your rheumatologist and other health care providers. They can help you weigh the potential benefits and risks, taking into account your overall health and existing treatment regimen​. Each individual’s health situation is unique, and having a personalized plan is essential to making the best decisions for your well-being.

Remember, managing lupus can be challenging, but with the right support and guidance from your health care team, you can navigate your options and take steps toward better health.

Connect With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 231,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

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