GLP-1s and Beyond: Integrating Metabolic Health into PsA and RA Care, with Eric Ruderman, MD

Cardiovascular and metabolic health have long been recognized as critical components of care in rheumatoid arthritis (RA) and psoriatic arthritis (PsA), but the recent growth of glucagon-like peptide-1 (GLP-1) receptor agonist use has positioned these aspects front and center in rheumatology care, with a growing emphasis on integrating systemic inflammation, obesity, and cardiometabolic risk more directly into therapeutic decision-making.

At the 2026 Rheumatology Winter Clinical Symposium (RWCS) held in Maui, Hawaii, on February 11-14, Eric Ruderman, MD, professor of rheumatology at Northwestern University Feinberg School of Medicine, addressed this evolving focus during his Year in Review presentations, highlighting how extra-articular facets of PsA and RA are increasingly shaping clinical strategy. RheumatologyLive sat down with Ruderman during the meeting to glean more insight into growing investigations in cardiovascular and metabolic health in RA and PsA.^1,2

Ruderman emphasized that clinicians are now looking more closely at the complex interplay between inflammation, metabolic syndrome, and obesity—particularly in PsA, where patients frequently present with overlapping psoriasis, axial involvement, and cardiometabolic comorbidities. The intersection of these domains complicates management decisions. In practice, treatment selection must account not only for joints, but also for skin and, in some cases, coexisting inflammatory bowel disease. Certain therapies may benefit multiple organ systems, while others require caution depending on gut involvement or axial disease. As phenotypes overlap more clearly, individualized, systems-based thinking has become essential.

One factor behind the growing focus on metabolic and cardiovascular health has been the increasing usage of glucagon-like peptide-1 (GLP-1)–based therapies. Although not primary rheumatologic treatments, these agents, originally developed for diabetes and weight management, are now being studied in combination with biologic therapies in PsA and psoriasis. Ongoing trials are evaluating whether adding a GLP-1–based agent to an IL-17 inhibitor improves disease control beyond what is achieved with biologic therapy alone, and whether any added benefit is purely weight mediated or reflects independent anti-inflammatory effects.

“I've had patients who've had RA for years and years, who say, ‘no matter what I've taken, I actually feel better than I have with anything… just with the addition of the GLP-1’. So there's something there, and it's not just weight loss, I don't think… In the next year two, I think we're going to learn a lot more about the use of these drugs. They're not going to be primary therapy, but as an adjunct to whatever else we're doing, I think they're going to have tremendous impact,” Ruderman said.

References

1. Ruderman E. Rheumatology 2025: Year in Review. What’s new in PsA. Presented at: RWCS 2026, February 11-14 in Maui, Hawaii.

2. Ruderman E. Rheumatology 2025: Year in Review. What’s new in Spondyloarthritis. Presented at: RWCS 2026, February 11-14 in Maui, Hawaii.