At the 2025 EULAR Congress, researchers presented real-world evidence suggesting that GLP-1 receptor agonists may lower symptom burden in patients with fibromyalgia, including reduced opioid use, pain, and fatigue.
The analysis used data from the TriNetX research network to compare two large cohorts of patients with fibromyalgia over a 5-year follow-up period. Patients were identified using ICD-10 code M79.7. One group included patients who received GLP-1 receptor agonists on at least two occasions, while the comparison group included those with no documented use of GLP-1 receptor agonists.
Before matching, 46,409 patients were identified in the GLP-1 group and 716,185 were identified in the non-GLP-1 group. After propensity score matching to balance demographics, comorbidities, BMI, hemoglobin A1c, and medication use, both groups consisted of 38,439 patients.
Outcomes included opioid use, fatigue, chronic pain, ongoing fibromyalgia care, disability, BMI, and hemoglobin A1c levels. Data were assessed starting 1 year after the index event and followed for 5 years.
Patients who received GLP-1 receptor agonists had significantly lower opioid use compared with those who did not (odds ratio [OR] = 0.6, risk difference = −12.6%, P < .001). Fatigue and malaise, identified through ICD codes R53.83, R53.81, and R53, were also lower in the GLP-1 group (OR = 0.576, risk difference −10.8%, P < .001).
Pain outcomes, which were measured using ICD codes G89.29, R52, and G89.2, showed reduced chronic and unspecified pain in the GLP-1 group (OR = 0.682, risk difference = −9.1%, P < .001).
The need for ongoing fibromyalgia care was also lower in the GLP-1 group, as were subsequent fibromyalgia diagnoses (OR = 0.512, risk difference = −16.6%, P < .001).
However, no significant difference was observed in disability, as defined by ICD code Z73.6 (OR = 0.953, risk difference = 0%, P = .827).
Both groups showed improvements in BMI and hemoglobin A1c, but the non-GLP-1 group had slightly lower values at follow-up. Patients who did not receive GLP-1 receptor agonists had a mean BMI of 34.1 kg/m² and A1c of 6.7%, compared with 35.3 kg/m² and 6.9% in the GLP-1 group.
The analysis controlled for confounders including diabetes, hypertension, obstructive sleep apnea, osteoarthritis, ischemic heart disease, hypothyroidism, and use of analgesics, NSAIDs, and antidepressants.
The researchers noted that while the findings suggest potential benefits of GLP-1 receptor agonists in fibromyalgia, the observational design limits causal conclusions. They recommended further evaluation through randomized controlled trials.
The authors reported no conflicts of interest.
Source: EULAR