New ACR Convergence Research Links Inflammatory Arthritis to Elevated Cardiovascular Risk and Identifies Major Gap in GLP-1 Treatment Uptake

Nationwide population study examines ischemic heart disease, heart attack, and cardiovascular mortality in inflammatory arthritis; real-world PsA cohort finds more than half of patients may be eligible for GLP-1 receptor agonists, while relatively few receive them.

ORLANDO — Two studies being presented at ACR Convergence 2026 highlight the substantial cardiovascular burden associated with inflammatory arthritis and identify an important gap in the use of therapies that may address cardiometabolic risk among patients with psoriatic arthritis (PsA).

The first study, “Risk of Ischemic Heart Disease, Myocardial Infarction, and Related Mortality in Inflammatory Arthritis: A Nationwide Population-Based Cohort Study” (Abstract 2455847), examines the occurrence of ischemic heart disease, myocardial infarction, and related mortality among people living with inflammatory arthritis. The research adds to a growing body of evidence that cardiovascular disease should be a central consideration in the long-term care of patients with inflammatory rheumatic conditions.

A second study, “GLP-1 Receptor Agonist Eligibility and Uptake and Their Relation With Psoriatic Arthritis Disease Activity and Cardiovascular Morbidity: Real-World Data from a Cardio-Rheumatology Cohort” (Abstract 2454244), evaluates eligibility for and real-world use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) among patients with PsA, rheumatoid arthritis, and axial spondyloarthritis. The findings suggest that many patients—particularly those with PsA—may be eligible for GLP-1 RA treatment but are not receiving it.

“Inflammatory arthritis affects far more than the joints,” said Sunghoon Cheong, MD, Samsung Medical Center, Seoul, presenting author of Abstract 2455847. “Our study focuses on the important relationship between chronic inflammatory disease and cardiovascular outcomes, including ischemic heart disease, heart attack, and mortality. These findings reinforce the need to identify cardiovascular risk early and address it as an integral component of rheumatologic care.”

Inflammatory arthritis is associated with systemic inflammation and may coexist with traditional cardiovascular risk factors, including obesity, diabetes, hypertension, dyslipidemia, and reduced physical activity. The nationwide population-based analysis evaluates the burden of ischemic heart disease, myocardial infarction, and related mortality in this patient population, underscoring the importance of coordinated preventive care involving rheumatology, primary care, and cardiovascular specialists.

The second study evaluated 834 patients with PsA, rheumatoid arthritis, or axial spondyloarthritis enrolled in the University of Toronto Cardio-Rheumatology Cohort. Researchers assessed GLP-1 RA eligibility and treatment uptake, as well as relationships between eligibility, inflammatory disease activity, and cardiovascular morbidity.

Overall, 47.5% of participants met criteria for GLP-1 RA therapy. Eligibility was especially common among patients with PsA: 56.7% met criteria for treatment. Eligibility increased from 46.1% at baseline to 56.2% after five years. However, despite this high level of potential eligibility, only 10.6% of eligible patients had received a GLP-1 RA by 2026.

Among patients with PsA, GLP-1 RA eligibility was associated with greater inflammatory disease burden, including higher Disease Activity in Psoriatic Arthritis scores, high-sensitivity C-reactive protein levels, pain, morning stiffness, fatigue, and physician global assessment scores. Eligible PsA patients also had a higher prevalence of diastolic dysfunction—29.8% compared with 17.7% among noneligible patients—along with a less favorable lipid profile and numerically higher coronary calcification.

“These results point to a meaningful treatment gap in a group of patients who often carry both inflammatory and cardiovascular risk,” said Lihi Eder, MD, PhD, clinician-scientist at Women’s College Research Institute and associate professor of medicine at the University of Toronto, principal investigator and presenting author of Abstract 2454244. “More than half of our patients with psoriatic arthritis met criteria for GLP-1 receptor agonist therapy, yet use remained low. This gap represents an opportunity to improve identification and treatment of modifiable cardiometabolic risk factors.”

GLP-1 RAs are used in the management of type 2 diabetes and obesity and can support clinically meaningful weight loss in appropriate patients. Although the results of the Toronto cohort study do not establish that GLP-1 RAs improve arthritis activity or cardiovascular outcomes in people with PsA, the findings emphasize the need to evaluate potentially eligible patients and to coordinate care across rheumatology, primary care, cardiology, endocrinology, and obesity medicine.

“Together, these studies make a compelling case for a more integrated approach to inflammatory arthritis,” said Howard H. Yang, MD, RhMSUS, a rheumatologist at UCLA Health and chair of ACR’s Communications and Marketing Committee. “Recognizing cardiovascular risk is only the first step. The next is ensuring that patients have access to evidence-based prevention, appropriate metabolic care, and coordinated follow-up that reflects the full impact of their disease.”

The researchers cautioned that GLP-1 RAs are not appropriate for every patient with inflammatory arthritis, nor are they replacements for disease-modifying therapies used to control rheumatic disease. Decisions about GLP-1 RA use should be individualized, considering disease activity, diabetes status, body weight, cardiovascular risk, potential medication adverse effects, contraindications, affordability, insurance coverage, and patient preferences.

Both abstracts will be presented at ACR Convergence 2026, the annual scientific meeting of the American College of Rheumatology, being held November 6–11 in Orlando, Florida.

Media Contact
Teri Arnold
Director, Public Relations & Communications
757-272-7002
tarnold@rheumatology.org

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About the American College of Rheumatology
Founded in 1934, the American College of Rheumatology (ACR) is a not-for-profit, professional association committed to advancing the specialty of rheumatology that serves nearly 10,500 physicians, health professionals, researchers and scientists worldwide. In doing so, the ACR offers education, research, advocacy and practice management support to help its members continue their innovative work and provide quality patient care. Rheumatology professionals are experts in the diagnosis, management and treatment of more than 100 different types of arthritis and rheumatic diseases.

About ACR Convergence
ACR Convergence, the annual meeting of the American College of Rheumatology, is where rheumatology meets to collaborate, celebrate, congregate, and learn. With hundreds of sessions and thousands of abstracts, it offers a superior combination of basic science, clinical science, business education and interactive discussions to improve patient care and advance the specialty. For more information about the meeting, visit the ACR Convergence page, or join the conversation on X by following the official hashtag (#ACR26).