GLP-1 Receptor Agonists Use Linked to Lower Cardiovascular Risk in Diabetic Patients with MGUS: Study

The researchers reported the following findings:

• GLP-1 RA use was associated with a 25% lower risk of major adverse cardiovascular or cerebrovascular events (HR: 0.75).
• Patients using GLP-1 RAs had a significantly reduced risk of all-cause mortality (HR: 0.57).
• The risk of new-onset heart failure was lower among GLP-1 RA users (HR: 0.69).
• A decreased risk of decompensated heart failure was observed in the GLP-1 RA group (HR: 0.60).
• GLP-1 RA use was linked to a reduced risk of acute kidney injury or end-stage kidney disease (HR: 0.73).

These results suggest that GLP-1 RAs may serve as a valuable tool for primary prevention of cardiovascular and renal complications in patients with MGUS and diabetes, a population that has not been specifically studied in major clinical trials.

However, the authors caution that the observational nature of the study limits definitive conclusions about causality. Other limitations include the use of administrative coding data, the inability to assess medication adherence or dosage, and a relatively small matched sample size. Moreover, the study population was largely drawn from academic medical centers, which may not reflect broader community settings.

The authors concluded, "Despite these constraints, the findings provide a compelling rationale for future randomized clinical trials to confirm the cardioprotective effects of GLP-1 RAs in this unique subgroup of patients. As the understanding of MGUS and its systemic effects continues to evolve, this study highlights the importance of tailored prevention strategies in complex metabolic and hematologic conditions."

Reference:

Chi K, Song J, Desphande S, et al. GLP-1 RA Use and Major Adverse Cardiovascular Events in Patients With Monoclonal Gammopathy of Undetermined Significance. JAMA Netw Open. 2025;8(6):e2517541. doi:10.1001/jamanetworkopen.2025.17541