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Important safety considerations include contraindications in patients with personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2, caution in those with a history of pancreatitis, increased risk of gallbladder disease, potential for acute kidney injury with dehydration, and possible worsening of diabetic retinopathy with rapid glycemic improvement
Furthermore, patients losing significant weight may increase physical activity levels, potentially exceeding their current conditioning and leading to exercise-associated muscle cramps
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Given the prominent role of IL-17driven inflammation in obese PsA patients, GLP-1RAs may also enhance the efficacy of biologic agents targeting these pathways
What has shifted is the intentionality behind those selections
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