Glucagon‐Like Peptide 1 Receptor Agonists, Sodium‐Glucose Cotransporter 2 Inhibitors, and Risk of Autoimmune Rheumatic Diseases
Authors' conclusion
Neither GLP-1RA nor SGLT2i treatment was associated with increased or decreased ARD risk versus DPP4i in adults with T2D; however, SGLT2i use was associated with significantly lower risk of SARDs, warranting further study.
Study context
- Population
- Adults with type 2 diabetes and no prior ARD initiating a GLP-1RA, SGLT2i or DPP4i, 2014–2022, Canadian province with universal health caremean follow-up 1.3 to 1.6 years
- Participants
- 229,300 adults
- Exposure
- GLP-1RA or SGLT2i initiation vs DPP4i initiation
- GLP-1RAsn = 49,514
- SGLT2in = 101,925
- DPP4in = 77,861reference
- Outcome
- Incident ARD (RA, psoriatic disease, axSpA, systemic ARDs) identified with validated algorithms
Methodological detailspropensity score weighting, Cox regression, administrative health data
- Propensity score weighting
- Cox regression
- Administrative health data
Main finding
As reported in the abstract
ARD incidence per 10,000 person-years (after propensity score (PS) weighting)
Each group vs DPP4iAdjusted hazard ratio (95% CI)
GLP-1RAs
1.04(0.81–1.33)
SGLT2i
0.93(0.75–1.16)
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| Systemic ARDs (SLE, SSc, Sjögren disease, IIM, systemic vasculitides)SGLT2ivs DPP4i | 0.51 (0.31–0.84) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Systemic autoimmune rheumatic diseases (ARDs) (SLE, SSc, Sjögren disease, IIM, systemic vasculitides)
- Risk of other diseases not lower with SGLT2i vs DPP4i
Original publication
Glucagon‐Like Peptide 1 Receptor Agonists, Sodium‐Glucose Cotransporter 2 Inhibitors, and Risk of Autoimmune Rheumatic Diseases. Arthritis Rheumatol. Published 24 February 2026. doi:10.
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