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Theoretical potential benefits (currently unproven for rheumatoid arthritis and not studied at microdose levels): Possible anti-inflammatory effects through modulation of immune pathways Weight reduction, which may indirectly benefit joint symptoms in overweight patients Cardiovascular risk reduction, relevant given increased cardiovascular disease risk in rheumatoid arthritis (established in type 2 diabetes populations at therapeutic doses only) [28] Improved metabolic parameters in patients with concurrent metabolic syndrome Known adverse effects of GLP-1 receptor agonists at standard doses include: Gastrointestinal symptoms : nausea, vomiting, diarrhoea, constipation, and abdominal discomfort (very common, affecting more than 1 in 10 patients) Hypoglycaemia : particularly when used with other glucose-lowering medications Injection site reactions : erythema, pruritus, or nodules Pancreatitis : rare but serious, requiring immediate medical attention if severe abdominal pain develops Gallbladder disease : increased risk of cholelithiasis and cholecystitis Thyroid effects : thyroid C-cell tumours observed in rodents

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