AAOS: GLP-1 Receptor Agonist Use Increases Five-Year Risk for Osteoporosis

FRIDAY, March 6, 2026 (HealthDay News) — Treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for type 2 diabetes and obesity is independently associated with a significantly increased five-year risk for osteoporosis, gout, and osteomalacia compared with nonuse, according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons, held from March 2 to 6 in New Orleans.

Muaaz Wajahath, from the Michigan State University College of Human Medicine in East Lansing, and colleagues evaluated the five-year risk for osteoporosis, gout, and osteomalacia in adults with both type 2 diabetes and obesity treated with GLP-1 RAs (semaglutide, liraglutide, dulaglutide, or exenatide) compared with matched controls (73,483 per group).

The researchers found that at five years, patients exposed to GLP-1 RAs had a significantly increased risk for osteoporosis compared with controls (4.1 versus 3.2 percent; risk ratio, 1.29). Gout incidence also was elevated among GLP-1 RA users (7.4 versus 6.6 percent; risk ratio, 1.12). Osteomalacia had the greatest relative risk increase, with a five-year incidence of 0.2 percent among GLP-1 RA users compared with 0.1 percent in the control group (risk ratio, 2.55). There was statistical significance for all differences in absolute and relative risk.

“We are just now reaching the precipice where five- and 10-year follow-up data are becoming available for patients taking GLP-1 medications,” Wajahath said in a statement. “Any medication that sees this rapid adoption warrants close examination, particularly in orthopedics where obesity and surgical intervention often overlap, and when the long-term effects of GLP-1 RA exposure on bone and joint health remain poorly understood.”

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