• Effect of Glucagon-like peptide-1 receptor agonists (GLP-1 RA) on serum uric acid concentration: A systematic review and meta-analysis
  • Milad Bahrami,1,* Sara Najafi,2 Amirhossein Sahebkar,3
    1. Student Research Committee, Faculty of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
    2. Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
    3. Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.


  • Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a class of medications used to treat type 2 diabetes. They improve glucose tolerance, increase insulin secretion, and induce weight loss. There is a controversy over the effect of GLP-1 RAs on serum uric acid (SUA) concentration. Our systematic review attempts to objectively answer whether GLP-1 agonists affect the serum levels of uric acid.
  • Methods: We performed a systematic search on Pubmed, Web of Science, Embase, Scopus and Google Scholar datasets up to 27 August 2021 with a language restriction of English only. Randomized controlled trials, observational studies, uncontrolled trials, and conference abstracts were included in, and studies with insufficient data, irrelevant types of study and follow-up duration of less than a month were excluded from the review. After critical appraisal by Joanna Briggs Institute checklists, articles underwent data extraction using a pre-specified Microsoft Excel sheet.
  • Results: Of 1004 identified studies, 20 were eligible for our systematic review. Pre- to post-administration analysis of GLP-1 RAs effects on SUA demonstrated that GLP-1 RA could significantly reduce SUA concentration (P-value<0.001). However, when compared to placebo, GLP-1 RAs did not significantly lower SUA concentration (P-value=0.122). Surprisingly, the active controls (including insulin, metformin, iGlar, SGLT-2 inhibitors, and DDP-4 inhibitors) could significantly alter SUA concentration more than GLP-1 RA (P-value<0.001).
  • Conclusion: The use of GLP-1 agonists can result in a significant reduction in the serum uric acid concentration. However, this reduction is not as much as that seen in insulin, metformin, iGlar, and SGLT-2 inhibitor users.
  • Keywords: Uric acid, Glucagon-like peptide-1 receptor agonists, GLP-1 RA, diabetes mellitus