Exploring the effects of GLP-1 receptor agonists in fibromyalgia: a propensity-matched real-world cohort using TriNetX research platform, 2026, Eshak+

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Exploring the effects of GLP-1 receptor agonists in fibromyalgia: a propensity-matched real-world cohort using TriNetX research platform

Nouran Eshak, Anushka Irani, Megan Sullivan

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Objectives
We aimed to evaluate the effects of GLP-1 receptor agonists (GLP-1RA) on symptom burden and opioid use in patients with fibromyalgia using real-world data.

Methods
We conducted a retrospective cohort study using the TriNetX Research Network. Patients with fibromyalgia (≥2 diagnostic encounters) were divided into two groups: those with and without ≥2 prescriptions for GLP-1RA. Propensity score matching at a 1:1 ratio for age, sex, and key comorbidities, including diabetes mellitus, obesity, osteoarthritis, inflammatory arthritis, ischemic heart disease, sleep disorders, migraine, and medication use, was performed.

Outcomes were assessed over a five-year follow-up period. This included opioid use, diagnostic codes for pain, fatigue, and disability, body mass index, and haemoglobin A1C. Statistical analysis included odds ratios, risk differences, and t-tests.

Results
After propensity score matching, there were 48 025 patients in each cohort. Baseline characteristics were well matched, though BMI and Haemoglobin A1c were higher in the GLP-1RA cohort than in non-GLP-1RA users.

GLP-1RA use was associated with significantly reduced odds of opioid prescription (OR 0.65), pain diagnostic codes (OR 0.79), and fatigue diagnostic codes (OR 0.68) (all p< 0.001). There was no significant difference in disability-related diagnostic codes.

BMI and HbA1C remained higher in patients on GLP-1RA.

Conclusion
GLP-1RA use was associated with reduced opioid prescription and a reduction in the use of ICD-10 codes related to fibromyalgia, potentially reflecting lower symptom burden.

Further studies using validated outcome measures are needed to confirm these findings.

Web | DOI | PDF | Rheumatology | Open Access
 
Potentially slightly interesting. If only the validity of recorded diagnoses was of value in itself in issues with no reliable tests. Most studies that rely on diagnostic codes for issues like this are pretty much studies into clinical practices, not patient or the problems they face. At least certainly for those three codes.

Because considering how next steps usually go for this, 15 years later we could have a handful of flawed trials, lots of speculation and confusion, but no actually useful information. At best.
 
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