A case of immune-mediated necrotizing myopathy (IMNM) was reported following semaglutide treatment, representing a rare but serious autoimmune adverse event requiring clinical awareness.
Rare autoimmune reactionSemaglutide's immunomodulatory effects rarely trigger autoimmunity — clinicians should consider IMNM in patients developing unexplained muscle weakness
What the researchers found
IMNM (immune-mediated necrotizing myopathy) following semaglutide — rare autoimmune muscle adverse event requiring clinical awareness for unexplained weakness during GLP-1 therapy.
Why it matters
Rare autoimmune events with widely prescribed drugs must be documented. Muscle weakness on GLP-1 drugs should trigger IMNM consideration.
How the study worked
Case report of IMNM developing after semaglutide initiation, with clinical documentation and immunological workup.
What this study cannot tell us
Single case. Cannot prove causation. IMNM has multiple triggers.
How to read the evidence
Case report of rare adverse event.
When this study was published
Published in 2025.
The bigger picture
GLP-1 drugs are immunomodulatory — usually beneficially, but rarely triggering autoimmune conditions like IMNM.
Questions still open
- How common is semaglutide-associated IMNM?
- Should muscle enzymes be monitored during GLP-1 therapy?
- Would stopping semaglutide and treating IMNM resolve the myopathy?
Common questions
Can semaglutide cause muscle disease?
Is this common?
Read the original research
Immune-mediated necrotising myopathy following semaglutide treatment: a contributing factor?
BMJ case reports, 19(3)
Citation
Lam, Brian; Tiniakou, Eleni; Zhang, Xinhai Robert; Assassi, Shervin. (2026). Immune-mediated necrotising myopathy following semaglutide treatment: a contributing factor?. BMJ case reports, 19(3). https://doi.org/10.1136/bcr-2025-269690