These findings suggest that GLP-1 receptor agonists may provide cardiovascular and vascular benefits beyond weight loss, potentially improving long-term outcomes in high-risk patients with obesity and autoimmune diseases. The study was published in the Journal of the American Heart Association by Hao Dai of Indiana University School of Medicine, Indianapolis, and colleagues.
Obesity and autoimmune diseases are associated with chronic inflammation and an elevated risk of cardiovascular and thromboembolic events. Although GLP-1 receptor agonists have shown cardiovascular benefits in obesity and type 2 diabetes, their impact in patients with coexisting autoimmune diseases has been unclear.
To investigate this, researchers conducted a target trial emulation using OneFlorida+ electronic health record data from 2014 to 2024. The study included adults with obesity and autoimmune diseases who were eligible for anti-obesity therapy.
After time-dependent propensity score matching, the analysis included 13,204 GLP-1 receptor agonist users and 13,204 non-users. The mean age was 54.7 years, 73.4% were women, and the average BMI was 37 kg/m².
The researchers assessed major cardiovascular and thromboembolic outcomes, including myocardial infarction, stroke/TIA, pulmonary embolism, venous thromboembolism, and coronary revascularization, as well as hospitalizations, emergency department visits, and all-cause mortality.
Key findings from the study included:
- GLP-1 receptor agonist use was associated with a 13% lower risk of stroke or transient ischemic attack.
- Users had a 31% lower risk of pulmonary embolism.
- The risk of venous thromboembolism was reduced by 17%.
- Emergency department visits were 21% less frequent among GLP-1 users.
- All-cause mortality was 44% lower in patients receiving GLP-1 receptor agonists.
- The analysis also suggested potential benefits for myocardial infarction, although these associations were less definitive.
The researchers noted that variations in autoimmune disease severity and cardiovascular risk may have affected the findings. They also acknowledged the potential influence of unmeasured factors, including disease activity, socioeconomic status, and immunosuppressive therapy use. Additionally, the observational design could not determine the specific mechanisms underlying the observed benefits.
The authors concluded that GLP-1 receptor agonist use was associated with lower risks of thromboembolic events, emergency department visits, and all-cause mortality in adults with obesity and autoimmune diseases. They emphasized the need for further studies to confirm these findings, clarify underlying mechanisms, and explore the preventive potential of these therapies in systemic inflammatory conditions.
Reference:
Dai H, Lee YA, Natalie A, Jackson W, Pham A, Levine J, Radwan RM, Guo J, Bian J, Sheer AJ. Glucagon-Like Peptide-1 Receptor Agonists and Cardiovascular Events in Adults With Obesity and Autoimmune Disease: A Target Trial Emulation. J Am Heart Assoc. 2026 Jun 6:e047893. doi: 10.1161/JAHA.125.047893. Epub ahead of print. PMID: 42250252.
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