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Do SGLT2 and GLP-1 therapies have a role in Lupus?

Maya Shumyatcher, MD,  , Arpitha Haranahalli Shivarudrappa, PhD , , Jennifer H. Anolik, MD, PhD

Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i) and Glucagon-like peptide-1 receptor agonists (GLP1-RA) were initially developed as glucose-lowering agents for the treatment of Type 2 Diabetes. Since their introduction, they have been noted to have a myriad of other benefits, including cardiovascular and renal protective effects in patients both with and without diabetes. Here, we will review the evidence for SGLT2i and GLP1-RA in lupus.

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Vitamin D Headlines (5.9.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and lupus highlights from the past week on RheumNow.com. Triple positivity, the gut and CRPS, and hope for better outcomes with Vitamin D therapy. 

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D-Lay Trial: High-Dose Vitamin D Retards Multiple Sclerosis

Jack Cush, MD

A randomized clinical trial with oral high-dose cholecalciferol ( vitamin D3) was shown to prevent or delay the onset of clinically isolated syndrome (CIS), typical for multiple sclerosis (MS).

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Secondary Benefits to SGLT2 Inhibitor Use in SLE

Jack Cush, MD

An emulation trial of sodium–glucose cotransporter 2 inhibitors (SGLT2i) in systemic lupus erythematosus patients yielded a significantly reduced risk of several cardiorenal complications among patients with SLE and type 2 diabetes.

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Metformin Effective in Osteoarthritis

MedPage Today

The diabetes drug metformin provided overweight/obese patients with osteoarthritis (OA) of the knee with significantly greater pain relief than did placebo in a small randomized trial, researchers said.

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Rheumatology: Believe It or Not (4/25/2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Should we believe the reviews and metanalyses?

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Vitamin D for Prevention of Disease

Jack Cush, MD

JAMA has published a clinical guideline on the use of vitamin D to prevent disease in children and adults.

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Diabetes Prevention with Hydroxychloroquine in Sjogren’s

Jack Cush, MD

A Taiwanese insurance claims analysis looked at hydroxychloroquine (HCQ) use in primary Sjögren syndrome (pSS) and showed that HCQ exposure significantly reduces the risk of new onset dia

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PPACMAN Consensus Recs. for CV risk in PSO/PSA published for Rheums/Derms/PCPs - check BP, Wt, Lipids, Cr. - Look for HTN, DM, smoking, obesity, metabolic synd. - Risk stratify w/ hsCRP, Lipids - Lifestyle management https://t.co/MkgYopTNAX https://t.co/6yyxVIxpC0

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Risk Factors for Knee Osteoarthritis New research from the University of Sydney reveals that obesity, having a knee injury and occupational risks such as shift work and lifting heavy loads are primary causes of knee osteoarthritis. https://t.co/Kc686Zc8Xa https://t.co/ANyiE2pIxo

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3-year, RCT of Mediteranean diet vs usual care in 924 older adults w/ metabolic syndrome & BMI > 27. Med. diet shows signif wt loss (3.4% vs 0.4%), w/ improved BMD (by DEXA) at year 3, especially in women. https://t.co/mllx6l1QnM https://t.co/I5e8PXX2oX

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Dr. John Cush RheumNow ( View Tweet)
3-year, RCT of Mediteranean diet vs usual care in 924 older adults w/ metabolic syndrome & BMI > 27. Med. diet shows signif wt loss (3.4% vs 0.4%), w/ improved BMD (by DEXA) at year 3, especially in women. https://t.co/mllx6l1QnM https://t.co/CulO1Sschf

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Finish Birth Cohort followed since 1986, who were asymptomatic, found abnormal MRI knee findings, esp cartilage defects in the patellofemoral (56%) & tibiofemoral joints (25%) joints. Small/doubtful patellofemoral (52%) & tibiofemoral (17%) osteophytes seen. Most w/ High BMI. https://t.co/nQKREE4XfU
Dr. John Cush RheumNow ( View Tweet)
GLP-1 agonists effective in Rxing MASH - metabolic dysfunction-assoc steatohepatitis (AKA NAFLD, NASH). DBRPCT w/ 1100 pts (mean BMI 34-35). A good perspective article from Sensible Medicine. https://t.co/NeaX5qcnPA https://t.co/5DHlKfH105 https://t.co/sCfvcm7g54

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Dr. John Cush RheumNow ( View Tweet)
Finish Birth Cohort followed since 1986, who were asymptomatic, found abnormal MRI knee findings, esp cartilage defects in the patellofemoral (56%) & tibiofemoral joints (25%) joints. Small/doubtful patellofemoral (52%) & tibiofemoral (17%) osteophytes seen. Most w/ High BMI. https://t.co/LHqmRHM5wF
Dr. John Cush RheumNow ( View Tweet)
GLP-1 agonists effective in Rxing MASH - metabolic dysfunction-assoc steatohepatitis (AKA NAFLD, NASH). DBRPCT w/ 1100 pts (mean BMI 34-35). A good perspective article from Sensible Medicine. https://t.co/NeaX5qcnPA https://t.co/loRPcwv8B9 https://t.co/ul8ko9cU4K

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Dr. John Cush RheumNow ( View Tweet)
D-Lay MS trial: DBRPCT of Oral cholecalciferol 100 000 IU q2wks x 24 mos.signif reduced Dz activity in clinically isolated syndr(CIS) & early relapsing-remitting MS typical for MS. Dz activity seen in 60% w/ Vit D vs 74% w/ PBO (HR 0.66). Also time to Dz activity (432 vs 224d; https://t.co/GQsnnuWS9R
Dr. John Cush RheumNow ( View Tweet)
Metformin Effective in Osteoarthritis The diabetes drug metformin provided overweight/obese patients with osteoarthritis (OA) of the knee with significantly greater pain relief than did placebo in a small randomized trial, researchers said. https://t.co/7krvFFfRFC https://t.co/XY5BtiXkOB

Links:

Dr. John Cush RheumNow ( View Tweet)
Vitamin D for Prevention of Disease JAMA has published a clinical guideline on the use of vitamin D to prevent disease in children and adults. Guideline committee experts, included adult and pediatric endocrinology, internal medicine, obstetrics/gynecology, nutrition, and https://t.co/zi3CpE0DVN
Dr. John Cush RheumNow ( View Tweet)
Obesity is a risk factor for not achieving remission in early #RA (ERA), independent of comorbidity. 1285 ERA RA pts; remission failure @6 mos = 64% w/ obese, 52% if overWt & 48% if NL wt. RR 1.33 w/ no change after adjusting for RF/CCP, education, EtOH, smoking, phys activity, https://t.co/341ba1rCSk
Dr. John Cush RheumNow ( View Tweet)
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