Grant: Project Grant

Nearly one-third of Canadian adults have obesity. Extra body fat leads to inflammation that can increase a person's risk of serious health problems like heart disease and diabetes, and even death. For people who have inflammatory arthritis (IA), e.g., rheumatoid arthritis, psoriatic arthritis, or axial spondyloarthritis, extra body fat can make their symptoms worse and their disease harder to treat. The diabetes medication semaglutide (branded as Ozempic) is effective at reducing excess weight and inflammation, but there isn't much research looking at how it affects people living with IA. By lowering weight and inflammation, we want to know if semaglutide can improve IA disease control in people with both IA and diabetes and whether it is safe for them. We aim to answer these questions in two steps, using regularly collected health data from British Columbia on people living with IA and diabetes. First, we will compare people who consistently took semaglutide for 6+ months to those who stopped taking it within 6 months of starting, before weight loss usually slows/stops. Second, we will compare the effects of semaglutide to those of another common type of diabetes drug that causes less weight loss (sodium-glucose cotransporter-2 inhibitors), and then see how each compares to not taking either drug. In both steps, we will look at how often people in each group needed to have their IA drug(s) increased (e.g., switched to a stronger set of immune-suppressing drugs and/or given steroids), as this is a sign their disease was not properly controlled. Because there are concerns that semaglutide may cause depression, suicidal thoughts, and diseases of the pancreas and gallbladder, we will also assess if people who took it had higher risks of visiting emergency rooms, being hospitalized, or dying from these causes. This project will provide important information about the safety of this increasingly popular drug and may guide next steps in research testing its effectiveness.