GLP-1 use for arthritis sparks access questions

GLP-1s are not FDA approved to treat rheumatoid arthritis, but some users report reduced inflammation and better quality of life, as Cassandra Smith explains.

I was too young to be waking up in pain. A GLP-1 helped me get my rheumatoid arthritis and weight under control.

Cassandra Smith, 30, lives with rheumatoid arthritis and weighs 311 pounds. Her doctor warned that weight and inflammation would threaten her health, and she tried dieting but still faced long flare ups. When GLP-1 medications were proposed for weight loss, Smith sought alternatives after her insurer said the drugs were for cosmetic purposes, turning to compounded tirzepatide from a local provider.

Seven months in, Smith says she has not had a single arthritis flare up and has lost about 69 pounds. She notes her inflammation has fallen, she has more energy, and she has changed her daily routines—from protein rich breakfasts to home workouts and more time with her 4 year old daughter. She describes a shift in her spending, moving from daily fast food to planned meals and groceries, and says she now considers herself in control of her health rather than letting illness drive her days.

Off label use of GLP-1 drugs carries safety and regulatory questions. While stories like Smith's show improved quality of life, more independent research is needed to understand how these drugs affect RA inflammation over time and how compounded versions compare to approved therapies. Access and cost also shape who can pursue this path, raising equity concerns as insurers differ in coverage. Doctors face a balance between patient autonomy and medical oversight in these cases.

Policy and guidance will influence whether this approach becomes more common. If more evidence supports safety and efficacy, clinicians may discuss GLP-1s as part of a broader strategy for inflammatory diseases; if not, patients may face a patchwork system that favors money over medicine.

Highlights

Health care decisions like this depend on science access and clear guidance from doctors and regulators.