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Beyond the Scale: Do GLP-1RAs Offer More Than Weight Loss in PsA?
Over 70% of patients with PsA struggle with excess weight, amplifying synovio-entheseal inflammation and blunting biologic response. The rapid uptake of GLP-1RAs in rheumatology has raised an urgent mechanistic question: are clinical gains in PsA driven purely by weight reduction, or do these agents carry intrinsic anti-inflammatory properties? EULAR 2026 offered six abstracts that together illuminate, without fully resolving, this question.
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CT imaging in RA
Body composition changes beyond BMI
489 RA vs 397 ctrl
RA asso w/
-increased subcutaneous fat
-increased intermuscular adipose tissue -poorer muscle quality
Looks like it represent “hidden obesity” with more by fat redistribution and myosteatosis
#OP0348
Aurelie Najm AurelieRheumo ( View Tweet)
Diet as a DMARD? The Evidence Is Still Hard to Swallow
Dietary interventions are rarely taken as seriously as pharmacological therapies in rheumatology. Yet patients ask about them constantly, and an increasing number of studies suggest that nutrition may influence disease https://t.co/BLrr3CNZMg
Dr. John Cush RheumNow ( View Tweet)
ETA+MTX vs triple therapy after MTX failure in #RA: machine learning-emulated RACAT trial (n=3,472 VA pts) confirms ETA+MTX modestly better overall. But smoking matters: benefit disappears in current smokers. Precision medicine from RWD. @RheumNow #EULAR2026 POS0255
Jiha Lee JihaRheum ( View Tweet)
💉Do GLP-1 agonists improve DMARD persistence in PsA/axSpA?
TriNetX real-world study (n=3,068): YES!
Better b/tsDMARD persistence and lower stroke & mortality risk
#POS0194 #EULAR2026 @rheumnow
Nelly ZIADE 🍀 Nellziade ( View Tweet)
@RheumNow HOT #Obesity session (7)
📢A call for action
Current RMD treatments ignore obesity:
They all target immune response but miss the metabolic-inflammatory loop
Breaking that cycle may be the missing piece
Obesity must be part of every rheumatology plan
#EULAR2026 @rheumnow
Nelly ZIADE 🍀 Nellziade ( View Tweet)
☂️What is an umbrella meta-analysis?
It's a meta-analysis of meta-analyses ☔️
⬇️This one showed the effect of diet supplementation on several RA outcomes
Unfortunately, most studies have low levels of evidence
#umbrella #rainy_London #EULAR2026 @rheumnow https://t.co/kYPchXEexn
Nelly ZIADE 🍀 Nellziade ( View Tweet)
🔥 TOGETHER-PsA (OP069) #EULAR2026 #EULARbest Ixekizumab + Tirzepatide vs IXE alone in PsA with obesity/overweight: ✅ Primary endpoint (ACR50 + ≥10% wt loss at W36): 31.7% vs. 0.8% (p<0.001) ✅ ACR50: 33.5% vs. 20.4% ✅ MDA: 26.3% vs. 15.3% (p=0.026) @rheumnow @DrLauraCoates https://t.co/6wh3S6khXw
Nelly ZIADE 🍀 Nellziade ( View Tweet)
⚖️ Does BMI outrank treatment in early PsA outcomes?
YES - SPEED trial AI analysis:
BMI #1 predictor of PASDAS at 1yr in 192pts
#OP0187 #EULAR2026 @RheumNow https://t.co/9cZG7AWau2
Nelly ZIADE 🍀 Nellziade ( View Tweet)
🦴 What drives enthesophytes in PsA?
SITE-SPECIFIC:
Pelvic driven by disease activity+BMI
Calcaneal by BMI+damage
in a 1596pts cohort
OP0182 #EULAR2026 @RheumNow https://t.co/4RxgjJ2V9u
Nelly ZIADE 🍀 Nellziade ( View Tweet)
@RheumNow WIN Nutrition session #EULAR2026 (4)
🌾 Gluten does NOT influence biologic response in RD, BELIEVE cohort, 197 pts. No need to go gluten-free unless celiac disease
🌱 Plants for Joints trial: plant-based diet + exercise → sustained DAS28&WOMAC improvement @ 2Y, RA/OA
@RheumNow
Nelly ZIADE 🍀 Nellziade ( View Tweet)
@RheumNow WIN Nutrition session at #EULAR2026 (3)
6.🍟 High UPF intake → increased RA risk (HR 1.06/SD), partly mediated by CRP. Not all NOVA-4 foods are equal
7.💊 Vit D supplementation significantly reduces SLE disease activity — MA of 10 RCTs, SMD −0.54 (p<0.00001).
@RheumNow
Nelly ZIADE 🍀 Nellziade ( View Tweet)
WIN Nutrition session at #EULAR2026 (2)
🐟 n-3 PUFAs reduce RA risk by 9–10% per SD increase — especially in genetically high-risk individuals.
🫒 Mediterranean diet reduces RA risk by 25% (HR 0.75) & SLE risk by 39% (HR 0.61) in UK Biobank studies.
@RheumNow
Nelly ZIADE 🍀 Nellziade ( View Tweet)
WIN Nutrition session at #EULAR2026 (1)
🫐Higher fruit intake → RR 0.88 & cereal intake → RR 0.87 for RA onset
🥩 Highest quartile of red & processed meat intake → nearly DOUBLE the risk of RA onset (OR 1.92, CI 1.11–3.35)
@rheumnow https://t.co/RhO08FXtLI
Nelly ZIADE 🍀 Nellziade ( View Tweet)
Oral GLP1s now coming to the market-Peptide based (can be given only on empty stomach),
Non peptide based (can be given anytime). Know about s/e and contraindications.
May have Rheumatic diseases indications soon. Imp for rheumatologists to be familiar.
#EULAR2026 @RheumNow https://t.co/KNudYN29PT
Links:
Bella Mehta bella_mehta ( View Tweet)
Weight management should be discussed!!
Obesity management will help rheumatic diseases. EULAR guidelines below. No ACR ones exist.
Best evidence in OA and Gout.
#EULAR2026 plenary @RheumNow https://t.co/hBu4YeXZbu
Bella Mehta bella_mehta ( View Tweet)
Metaflammation !! A new term I learnt at #EULAR2026 plenary. @RheumNow
Inflammation triggered by metabolic abnormalities.
This may be the reason a lot of our inflammatory arthritis patients on GLP1 drugs(other indications) have thier disease activities improving. Emerging data.
Bella Mehta bella_mehta ( View Tweet)
💉 IXE+TZP beat IXE alone in obese PsA?
YES - TOGETHER-PsA RCT
33.5% vs 20.4% ACR50 at week 36 in 271 patients
OP069 #EULAR2026 @RheumNow
@DrLauraCoates @AlexisOgdie https://t.co/orvAe38alc
Nelly ZIADE 🍀 Nellziade ( View Tweet)
🥗 Does diet improve PsA?
DIPSA RCT: Mediterranean/DASH/Standard all improved DAPSA in 92pts
Weight loss drove outcomes
OP070 #EULAR2026 @RheumNow https://t.co/k5y7bvDbDQ
Nelly ZIADE 🍀 Nellziade ( View Tweet)
Psoriatic arthritis #PsA sessions raised important topics on intercepting arthritis in psoriasis, treating obesity as a disease target, synovial biopsy to guide treatment, molecular imaging to reveal subclinical disease. More tomorrow. #Rheumatology @RheumNow #EULAR2026
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
