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TOPLINE
Among patients with ulcerative colitis (UC), GLP-1 receptor agonist (RA) therapy was associated with substantially higher symptomatic remission rates at 12 weeks than no GLP-1 RA therapy, with benefits appearing independent of weight loss; remission rates were higher with semaglutide than liraglutide.
METHODOLOGY
- Although previous studies linked GLP-1 RA use to favorable inflammatory bowel disease outcomes and no increase in disease flares, its direct effect on UC disease activity, particularly symptomatic remission, remains unclear.
- Researchers conducted a retrospective cohort study using electronic health records from a single tertiary academic health system to evaluate the association between GLP-1 RA therapy and symptomatic remission in patients with UC.
- A total of 150 patients with UC who received GLP-1 RA therapy (mean age, 46 years; 54.7% women) were matched with 150 control patients who did not receive the therapy (mean age, 47 years; 53.3% women); 80 patients in the GLP-1 RA group received semaglutide and 70 received liraglutide.
- The majority of patients (approximately 80%) in both groups had a BMI ≥ 30.
- The primary outcome was symptomatic remission at 12 weeks; symptomatic remission was defined as a partial Mayo score ≤ 2 with a rectal bleeding subscore of 0, indicating minimal to no symptoms and specifically no visible blood in the stool.
TAKEAWAY
- At 12 weeks, patients who received GLP-1 RA therapy had higher symptomatic remission rates than control patients (66.7% vs 25.3%; P < .001). The mean partial Mayo scores improved from 5.8 at baseline to 2.1 at 12 weeks in the GLP-1 RA group and from 5.7 at baseline to 4.6 at 12 weeks in the control group (P < .001 for the between-group comparison).
- After adjustment, GLP-1 RA use was associated with nearly sixfold higher odds of symptomatic remission (odds ratio, 5.90; P < .001); semaglutide was linked to 77% higher odds of remission than liraglutide (P = .04).
- Weight loss was not associated with symptomatic remission (P = .41).
- GLP-1 RA therapy was generally well tolerated, with mostly mild gastrointestinal adverse effects, such as transient nausea and occasional vomiting, and no treatment discontinuations due to side effects during the 12-week follow-up.
IN PRACTICE
"Notably, clinical improvement preceded meaningful weight loss, supporting a potential weight-independent anti-inflammatory mechanism," the authors wrote.
"These real-world findings support a potential adjunctive role for GLP-1 RAs in UC," they added.
SOURCE
The study was led by Budoor Alqinai, MBChB, MSc, West Virginia University, Morgantown, West Virginia. It was published online in Inflammatory Bowel Diseases.
LIMITATIONS
The retrospective study design limited causal interpretation of the findings. Reliance on routine clinical records may have led to variability in partial Mayo score assessment. The predominance of patients with obesity or other metabolic comorbidities may have limited the applicability of the findings to the broader population of patients with UC.
DISCLOSURES
The authors declared no specific funding for the study and no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
