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The Potential for GLP-1s in the Treatment of Gout

Medically Reviewed By Jennie Olopaade, PharmD, RPH

Originally approved for type 2 diabetes treatment, GLP-1 medications are being repurposed for several other conditions. However, the research in some conditions, such as gout, does not always support the hype.

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Glucagon-like peptide 1 (GLP-1) analogs seem to be the latest darling of the pharmaceutical world. Here is a look at early evidence and hypotheses for how they might work in treating gout.

Glucagon-like peptide 1 and its effects

GLP-1 is an incretin hormone Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , meaning it is secreted in the gut in response to food to help manage blood glucose levels. Its effects include:

  • stimulating insulin release
  • inhibiting glucagon release
  • slowing gastric emptying
  • reducing appetite by increasing satiety

These GLP-1 effects may be impaired or absent in people with type 2 diabetes. GLP-1 analogs can help restore the homeostasis between these processes by binding to GLP-1 receptors. Because of this, they go by various other names, including GLP-1 agonists, GLP-1 receptor agonists, and incretin mimetics.

As drugs in this class were used to treat people with type 2 diabetes, several positive side effects emerged. People on these drugs lost weight and did not feel as hungry as usual.

This eventually led to their study and approval in the treatment of obesity for people with or without diabetes. As weight-loss drugs, some members of this class may promote the shedding of more than 10-15% Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  of a person’s body weight.

Researchers studying GLP-1 found that the hormone has receptors and effects outside the gut. Its effects appear throughout various organ systems, including the cardiovascular, respiratory, nervous, and skeletal systems. It can help protect nerves, improve cardiac output, and reduce inflammation.

In addition to these effects, researchers are interested in how it may affect diseases and conditions that tend to occur with type 2 diabetes, such as gout.

Data on GLP-1 analogs in gout 

The data regarding the use of GLP-1 analogs in people with gout are limited. Over the years, results were inconsistent about their effect on serum uric acid (SUA) levels.

One recent review aimed to settle the issue with two meta-analyses of the relevant literature. The first analysis looked at GLP-1 analogs and whether they could significantly reduce SUA levels. The results suggest that they can. 

The second analysis focused on the comparison of GLP-1 analogs to controls. Results showed that the reduction in SUA levels was not statistically different from placebo and that active controls, such as sodium-glucose co-transporter 2 (SGLT-2) inhibitors, were better at lowering SUA levels.

Even so, while high SUA levels are a risk factor Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  for gout, they do not always cause the condition. It is possible to have standard SUA measurements and still have gout. Conversely, it is also possible to have high SUA levels and not have problems with gout. So, it seems reasonable to study GLP-1 analogs in people with gout, not just elevated SUA levels.

Another recent review of GLP-1 analogs in inflammatory forms of arthritis, including gout, found no such study. The only gout-related study the reviewers found looked at the incidence of gout in people with type 2 diabetes taking SGLT-2 inhibitors or GLP-1 analogs. In this single study, the results favored SGLT-2 inhibitors again.

There is a lack of data on the role of GLP-1 analogs in gout. The little available research suggests that other anti-diabetes medications are more effective at lowering SUA levels and possibly reducing the incidence of gout. This is an area of research that should be addressed in the future.

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  2. Jensterle M, et al. (2022). Efficacy of GLP-1 RA approved for weight management in patients with and without diabetes: A narrative review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9063254/
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  5. Najafi S, et al. (2022). The effect of glucagon-like peptide-1 receptor agonists on serum uric acid concentration: A systematic review and meta-analysis. https://bpspubs.onlinelibrary.wiley.com/doi/10.1111/bcp.15344
  6. Soares R, et al. (2021). Why does hyperuricemia not necessarily induce gout? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918342/

Medical Reviewer: Jennie Olopaade, PharmD, RPH
Last Review Date: 2023 Dec 20
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