Treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for type 2 diabetes and obesity is independently associated with a significantly increased five-year risk for osteoporosis, gout, and osteomalacia compared with nonuse, according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons, held from March 2 to 6 in New Orleans.
Muaaz Wajahath, from the Michigan State University College of Human Medicine in East Lansing, and colleagues evaluated the five-year risk for osteoporosis, gout, and osteomalacia in adults with both type 2 diabetes and obesity treated with GLP-1 RAs (semaglutide, liraglutide, dulaglutide, or exenatide) compared with matched controls (73,483 per group).
The researchers found that at five years, patients exposed to GLP-1 RAs had a significantly increased risk for osteoporosis compared with controls (4.1% versus 3.2%; risk ratio, 1.29). Gout incidence also was elevated among GLP-1 RA users (7.4% versus 6.6%; risk ratio, 1.12). Osteomalacia had the greatest relative risk increase, with a five-year incidence of 0.2% among GLP-1 RA users compared with 0.1% in the control group (risk ratio, 2.55). There was statistical significance for all differences in absolute and relative risk.
“We are just now reaching the precipice where five- and 10-year follow-up data are becoming available for patients taking GLP-1 medications,” Wajahath said in a statement. “Any medication that sees this rapid adoption warrants close examination, particularly in orthopedics where obesity and surgical intervention often overlap, and when the long-term effects of GLP-1 RA exposure on bone and joint health remain poorly understood.” https://medicalxpress.com/news/2026-03-aaos-glp-receptor-agonist-year.html
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