Patients with immune diseases and type 2 diabetes taking GLP-1RAs had a lower chance of death compared to those taking DPP-4is. Credit: Buravleva stock via Shutterstock.

Certain diabetes medications such as Novo Nordisk’s Ozempic (semaglutide) reduced the risk of death and heart attacks in patients with immune-mediated inflammatory diseases (IMIDs), who also have type 2 diabetes (T2D).

The study, conducted by Arthritis Research Canada, analysed electronic health records from 10,855 adult patients with various autoimmune diseases and T2D taking either glucagon-like peptide-1 receptor agonists GLP-1RAs or dipeptidyl peptidase 4 inhibitors (DPP-4i) in British Columbia over two years.

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Those who took GLP-1RAs had fewer major cardiovascular events (MACE) and deaths compared to those taking DPP-4i, a common type of T2D medication. For every 1,000 people, 8.5 deaths occurred in the group on GLP-1RAs, versus 17.9 in the cohort with DPP-4i. This means that the risk of dying was about half as high with GLP-1RAs compared to DPP-4i’s.

IMIDs such as rheumatoid arthritis, psoriasis, and lupus, often cause chronic inflammation that can damage blood vessels and increase the risk of heart disease. This inflammation can also contribute to insulin resistance, a key factor in developing T2D.

GLP-1RAs mimic the effects of the GLP-1 hormone, helping to regulate appetite and blood sugar levels. Novo Nordisk and Eli Lilly are the two biggest players in the space, with many other pharma companies jumping on the bandwagon.

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Novo Nordisk’s semaglutide is marketed as Ozempic for T2D, and Wegovy for obesity. Eli Lilly’s tirzepatide is called Mounjaro when packaged as a medication for diabetes, and Zepbound for weight loss. The GLP1-RA market is booming, with Lilly’s Mounjaro and Novo’s Ozempic pulling in $5.16bn and $13.9bn in 2023 respectively, according to the respective companies’ financials. The companies are now looking for expanded labels to increase the reach of the blockbuster drugs.

In March 2024, the US Food and Drug Administration (FDA) approved a label update for Novo’s Wegovy to include its use as a measure to reduce the risk of cardiovascular death, heart attack, and stroke in adults with heart disease who are diagnosed as obese or overweight. However, their effects on individuals with autoimmune diseases have not been thoroughly investigated, as per Arthritis Research Canada, which sponsored the study.

The findings suggest that GLP-1-RAs may offer a critical advantage in managing diabetes and cardiovascular risk in patients with inflammatory arthritis, said the principal investigator of the study and senior research scientist with Arthritis Research Canada, Dr Antonio Aviña-Zubieta.

In the announcement accompanying the study results, Aviña-Zubieta said: “Given the increased risk of heart disease in this population, the study highlights the potential of GLP-1 receptor agonists as a preferred treatment option for diabetes, paving the way for improved health outcomes and longevity.”