I have no affiliation with any pharmaceutical company, and I continue to be cautious about the Glucagon-like peptide receptor agonist (GLP-1 RA) craze. However, I am paying attention to this family of drugs because for more than three decades I have watched with a feeling of growing helplessness as the average weight of my patients continued its upward trajectory, along with the list of associated health complications. I had to get bigger chairs in the waiting room, a scale that could weigh patients up to 700 lbs, a special electric wheelchair that could handle patients up to 700 lbs, and new exam tables that could handle very heavy patients. Over the years, I went from seeing patients who weighed over 300 lbs to patients who weighed over 600 lbs. Their non-healing wound(s) were a symptom of all their associated medical problems, and the root of nearly all these problems was obesity. I have been putting band aids (well, dressings) on the symptom and have had nothing to offer the underlying problem. This family of drugs is the first real hope I have had to change the trajectory of the crisis. I am worried about a lot of issues related to these drugs – because the real problem is what and how much people eat. (I can say that because I have fought a battle with my own weight for decades.) However, these drugs might provide some hope that, until now, has been lacking.

An article in JAMA Network Medical News & Perspectives discusses the potential use of the GLP-1 Receptor Agonists to treat addiction, Alzheimer’s and perhaps other conditions. It discusses the fact that patients may be more likely to stop smoking and perhaps other addictive substances like alcohol and perhaps even cocaine.

Personally, I am most interested in their possible anti-inflammatory effects. A friend who started taking a GLP-1RA for weight loss mentioned that their refractory hip bursitis disappeared within two weeks of starting the drug. Looking into it, I found this article about their anti-inflammatory properties.

I am fascinated by this potential anti-inflammatory effect because data from the US Wound Registry shows that nearly 16% of patients with diabetic foot ulcers also have an autoimmune or inflammatory condition.  That number is astounding! Glucagon-like peptide 1 receptor agonists have emerged as promising therapeutic agents with potent anti-inflammatory properties. The article says:

“GLP-1RAs may modulate inflammatory responses since GLP-1 receptors are present in immune cells such as macrophages, monocytes, and lymphocytes.^24,35 Through their interactions with GLP-1RAs, immune cell signals are modulated inside the cell. Pro-inflammatory cytokines, including TNF-α, IL-6, and IL-1β, are suppressed by GLP-1R in immune cells.^33,36 Furthermore, GLP-1RAs can boost the generation of anti-inflammatory cytokines such as IL-10, which helps to mitigate inflammation and restore immune balance.³³ However, there is strong evidence that central and peripheral immune responses undergo pathological alterations and develop with time.³⁷”

I do not have a financial interest in the use of these drugs. But I do care about finding help for patients.

Caroline Fife, M.D.

Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos

The opinions, comments, and content expressed or implied in my statements are solely my own and do not necessarily reflect the position or views of Intellicure or any of the boards on which I serve.