OP0281 EXPLORING GLP-1 AGONISTS EFFECTS IN FIBROMYALGIA PATIENTS: A PROPENSITY MATCHED ANALYSIS USING TriNetX DATABASE

Abstract

<h2>Abstract</h2><h3>Background:</h3> Fibromyalgia is a chronic pain syndrome characterized by widespread pain, fatigue, and a significant impact on quality of life. Management often relies on symptomatic treatments, including opioids and antidepressants, with varying efficacy and safety profiles. Emerging evidence suggests that glucagon-like peptide-1 (GLP-1) receptor agonists may have broader benefits beyond glucose regulation and weight loss, including potential analgesic and anti-inflammatory effects. <h3>Objectives:</h3> This study hypothesizes that GLP-1 receptor agonists can reduce the symptom burden in patients with fibromyalgia. The objective is to assess the impact of GLP-1 receptor agonists on opioid use, fatigue, pain, and ongoing care needs in this population. <h3>Methods:</h3> A propensity-matched cohort analysis was performed using the TriNetX research network. Cohort A included patients with a documented diagnosis of fibromyalgia (ICD-10: M79.7) and the use of GLP-1 receptor agonists on at least two separate occasions. Cohort B consisted of patients with fibromyalgia documented twice with no documented use of GLP-1 receptor agonists. The index date is defined as the date the patient is first included in the analysis which is the time they first meet the cohort criteria. The original cohort sizes were 46,409 patients in Cohort A and 716,185 patients in Cohort B. Using propensity score matching, the two groups were balanced for age, gender, comorbidities (including diabetes mellitus, hypertension, obstructive sleep apnea, other inflammatory and soft tissue disorders, osteoarthritis, ischemic heart disease, and hypothyroidism), hemoglobin A1c levels, body mass index (BMI) categories, and the use of medications (opioid analgesics, non-opioid analgesics, non-steroidal anti-inflammatory drugs, and antidepressants).The final cohorts consisted of 38,439 patients each after matching baseline characteristics displayed in Table 1. Outcomes were assessed over a 5-year follow-up period, beginning 1 year after the index event, these included opoid use, fatigue, malaise, chronic pain, continued care for fibromyalgia, BMI and hemoglobin A1C levels. <h3>Results:</h3> Opioid use was evaluated based on documentation of any administration of opioid analgesics, revealing a significantly lower risk in Cohort A (GLP-1) compared to Cohort B (No GLP-1), with an odds ratio of 0.600 and a risk difference of -12.6% (p<0.001).Fatigue and malaise were evaluated using ICD codes R53.83 (Other fatigue), R53.81 (Other malaise), and R53 (Malaise and fatigue), showing reduced prevalence in Cohort A (odds ratio: 0.576, risk difference: -10.8%, p<0.001). Pain outcomes, identified through ICD codes G89.29 (Other chronic pain), R52 (Pain, unspecified), and G89.2 (Chronic pain, not elsewhere classified), demonstrated lower rates of pain in Cohort A compared to Cohort B (odds ratio: 0.682, risk difference: -9.1%, p<0.001). Ongoing fibromyalgia care was determined by subsequent entries of the ICD code M79.7 (Fibromyalgia), with Cohort A showing reduced reliance on care (odds ratio: 0.512, risk difference: -16.6%, p<0.001). Disability, assessed using ICD code Z73.6 (Limitation of activities due to disability), showed no significant difference between the cohorts (odds ratio: 0.953, risk difference: 0%, p=0.827). Both cohorts had improvements in their BMI and hemoglobin A1c from baseline; however, Cohort B continued to demonstrate lower BMI and A1c values at follow-up, with a mean BMI of 34.1 kg/m² and A1c of 6.7% compared to Cohort A, which had a mean BMI of 35.3 kg/m² and A1c of 6.9%. <h3>Conclusion:</h3> This study supports the hypothesis that GLP-1 receptor agonists may reduce the symptom burden in fibromyalgia patients, particularly with regard to opioid dependency, fatigue, and pain. These findings suggest that GLP-1 receptor agonists could represent a novel therapeutic option in fibromyalgia management. Improvement in BMI, glucose control or other residual confounders may contribute to these outcomes. Further exploration through randomized controlled trials would be needed. <h3>REFERENCES:</h3> [1] Halloum, W., Dughem, Y.A., Beier, D. <i>et al.</i> Glucagon-like peptide-1 (GLP-1) receptor agonists for headache and pain disorders: a systematic review. <i>J Headache Pain</i> <b>25</b>, 112 (2024). <b>Table 1.</b> Baseline Characteristics of the cohorts after matching. <b>Table 2:</b> Result Summary <h3>Acknowledgements:</h3> <b>NIL</b>. <h3>Disclosure of Interests:</h3> <b>None declared</b>. © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.