The effect of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on osteoarthritis (OA) risk in people with type 2 diabetes mellitus (T2DM) remains uncertain, with previous studies reporting inconsistent findings. A meta-analysis published in Acta Diabetologica evaluated associations between GLP-1RA therapy and OA risk in adults with T2DM using evidence from randomized controlled trials (RCTs).

The analysis included 74 RCTs involving 105,415 adults with T2DM. Studies comparing GLP-1RAs with placebo, insulin, or oral antidiabetic drugs (OADs) were identified through searches of PubMed, Embase, Web of Science, ClinicalTrials.gov, and the Cochrane Library through May 6, 2025. Conventional pairwise meta-analysis, frequentist network meta-analysis, subgroup analyses, and sensitivity analyses were performed to evaluate OA risk across GLP-1RA formulations, treatment durations, and comparator groups.

Findings

• No statistically significant difference in OA risk was observed between GLP-1RAs and placebo, insulin, or OADs in conventional pairwise meta-analysis.
• Subgroup analyses based on GLP-1RA formulation, treatment duration, and comparator type also showed no significant differences in OA risk across evaluated groups.
• Network meta-analysis showed no notable differences in OA risk between GLP-1RAs and control interventions.
• No significant OA risk differences were observed among individual GLP-1RA formulations in the network meta-analysis.
• Sensitivity analyses confirmed the stability and reliability of the overall findings.

The analysis showed no significant difference in OA risk between GLP-1RA therapy and placebo, insulin, or oral antidiabetic drugs in adults with T2DM. Similar findings were observed across different GLP-1RA formulations, treatment durations, and comparator groups.