Effects of GLP ‐1 Receptor Agonists on Hyperuricemia, Serum Uric Acid and Gout: A Systematic Review and Meta‐Analysis
Pooled result · Serum uric acid (SUA)Result — go to the resultWeighted mean difference [WMD] −0.44 mg/dL 95% CI −0.52 to −0.35Authors' conclusion
Incretin-based therapies were associated with modest reductions in SUA and with a lower incidence of gout flares and hyperuricemia, an effect largely related to weight loss. The clinical relevance of these effects, and the mechanism of any weight-independent component, remains uncertain and warrant confirmation in dedicated trials.
Study context
- Population
- RCTs of ≥ 12 weeks' duration of GLP-1 RAs and dual GIP/GLP-1 receptor agonists reporting serum uric acid (SUA) change, gout flares or hyperuricemia incidenceparticipants in eighteen RCTs
- Participants
- 77,942 rcts
- Comparison
- Incretin-based therapy versus control
- Outcome
- Serum uric acid (SUA)
Methodological detailsRandom-effects meta-analysis, subgroup and sensitivity analyses, meta-regression
- Random-effects meta-analysis
- Subgroup and sensitivity analyses
- Meta-regression
Pooled result
As reported in the abstract
Weighted mean difference [WMD]
−0.44 mg/dL
95% CI −0.52 to −0.35
Incretin-based therapyvs control
weighted mean difference [WMD] −0.44 mg/dL (95% CI −0.52 to −0.35)
Further pooled results
| Outcome | Estimate | |
|---|---|---|
| Incident gout flaresIncretin-based therapyvs control | hazard ratio [HR] 0.62 (95% CI 0.53–0.72) | |
| Hyperuricemia incidenceIncretin-based therapyvs control | odds ratio [OR] 0.61 (95% CI 0.53–0.70) | |
| 0.512Ratio (log scale) |
mg/dL
| Outcome | Dual GIP/GLP-1 RA (tirzepatide) | Mono GLP-1 RAs | P value |
|---|---|---|---|
| SUA lowering by drug classGreater SUA lowering with dual GIP/GLP-1 RA | −0.62 | −0.35 | P = 0.001 |
Body-weight loss as moderator of SUA reduction (meta-regression)
- β per kg
- −0.041 mg/dL per kg, p < 0.001
- Between-trial heterogeneity explained
- 84.7%
- Weight-independent intercept
- −0.19 mg/dL, p < 0.001
Sensitivity analyses
- The SUA reduction was robust in all sensitivity analyses, including restriction to placebo-controlled trials
GRADE certainty
- GRADE certainty was high for SUA and moderate for gout flares (owing to small-study effects) and hyperuricemia incidence
Original publication
Effects of GLP ‐1 Receptor Agonists on Hyperuricemia, Serum Uric Acid and Gout: A Systematic Review and Meta‐Analysis. Diabetes Obes Metab. Published 8 November 2026. doi:10.
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