The Potential Indirect Impact of GLP-1 Receptor Agonists in the Management of Fibromyalgia

Fibromyalgia (FM) syndrome is typified by constant and pervasive musculoskeletal pain and may be comorbid with obesity. Glucagon Peptide 1 Receptor Agonists (GLP-1RAs) are relatively new pharmacotherapies developed for the treatment of type 2 diabetes mellitus (T2DM) and repurposed for the treatment of obesity. In addition to their well-established impact on glucose balance, new evidence indicates that GLP-1RA may have anti-inflammatory properties beyond glycaemic regulation. Modulation of central pain pathways by GLP-1RAs has been proposed in patients with FM, but few studies have directly evaluated the effects of GLP-1RAs on central pain. Hence, the purpose of this study is to review the relationship between FM and obesity and explore the potential role of GLP-1RAs in the management of FM.A literature search was conducted across four da-tabases - PubMed/Medline, Cochrane, Google Scholar, and PEDro, up to May 2025. The literature was sparse, and no formal evaluation process was performed; however, papers were excluded if they failed to address either FM or GLP-1RA. There was no formal risk-of-bias assessment for each included paper. Key characteristics of each study were extracted and summarized in table form to enable efficient narrative synthesis. Of the 56 included studies, 24 were preclinical reviews, 16 were clinical reviews, 8 were preclinical animal models, and only 8 focused on human data, limited to retrospective analyses of data and self-report. There is some evidence that GLP-1RAs may reduce neuronal excita-bility, inhibit pain signalling, and decrease inflammation. However, given the lack of clinical trials, it is difficult to draw firm conclusions regarding the potential role of GLP-1RA in the management of FM with comorbid obesity.