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"This suggests that it is primarily the amount of GLP-1 circulating in the body that determines how much reaches the joint." The study also detected DPP-4 (dipeptidyl peptidase-4), an enzyme that breaks down GLP-1, in synovial fluid a finding the authors note has implications for the design of any joint-targeted GLP-1 therapy, since a drug delivered directly into a joint would face enzymatic degradation

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By then, its often too late, says Natalie Rasgon, a neuroendocrinologist at the Icahn School of Medicine at Mount Sinai in New York City and director of the Center for Neuroscience in Womens Health at Stanford University