GLP-1 Agonists Show Promise in Slowing Kidney Disease in Lupus Nephritis Save

Glucagon-like peptide-1 receptor agonists (GLP-1Ra) have transformed the treatment landscape for type 2 diabetes and obesity. By enhancing insulin secretion, suppressing glucagon release, and slowing gastric emptying, GLP-1Ras enable better glucose control and weight management. They’ve also shown promise beyond glycemic control, reducing albuminuria in diabetic patients—a benefit believed to be largely independent of blood sugar levels.

Recent research has highlighted further anti-inflammatory benefits of GLP-1Ras, which help lower levels of pro-inflammatory cytokines and suppress inflammatory pathways involving TNF-α, IL-17, and NF-κB. These effects may explain their emerging therapeutic value in other chronic conditions, especially among patients with multiple health issues.

A retrospective cohort study (abstract 2579) presented at #ACR24 explores the benefits of GLP-1Ras in reducing the risk of end-stage renal disease (ESRD) for patients with lupus nephritis (LN). Drawing on data from the TrinetX global research database, the study examines how GLP-1Ras may reduce ESRD progression in a population where 10-20% progress to ESRD within five years, even with immunosuppressive therapies.

The study included LN patients diagnosed from 2014 to 2024. Researchers used propensity score matching to compare 554 LN patients treated with GLP-1Ras to 518 LN patients who had not used the drug, ensuring a comparable baseline. Excluding patients who already had ESRD, the results showed that LN patients not on GLP-1Ras were twice as likely to progress to ESRD or dialysis dependence within five years compared to those using GLP-1Ras (OR 2.35, 95% CI 1.39, 3.976).

These findings suggest that GLP-1 receptor agonists may have kidney-protective effects in lupus nephritis, likely due to their anti-inflammatory properties. As these agents continue to be recognized for their versatility and efficacy, they are becoming valuable options in managing complex health conditions, offering new hope for patients with autoimmune diseases and multimorbidities.