TOPLINE:

In patients with inflammatory bowel disease (IBD) and coexisting obesity and/or type 2 diabetes (T2D), the use of GLP-1 receptor agonists (RA) was associated with significant weight loss and a reduced risk for surgery; however, no significant link was found between the use of GLP-1 RA and the odds of corticosteroid or advanced therapy initiation or the rate of intestinal obstruction.

METHODOLOGY:

• Obesity in patients with IBD is linked to worse outcomes, including higher rates of hospitalization and surgery. As GLP-1 RA provide metabolic benefits in patients with obesity and diabetes, researchers were interested in the impact the drugs might have on clinical outcomes in patients with IBD.
• They conducted a systematic review and meta-analysis of 11 observational studies involving 16,242 patients with IBD who were treated with GLP-1 RA. The studies assessed the effects of GLP-1 RA (semaglutide, liraglutide, dulaglutide, or tirzepatide) vs non-GLP-1 RA or placebo therapies on clinical outcomes in patients with IBD and coexisting obesity and/or T2D.
• Study outcomes included weight loss, hospitalization, corticosteroid initiation, treatment escalation to advanced therapies, and surgery.

TAKEAWAY:

• GLP-1 RA use was associated with significant weight loss in patients with IBD and obesity and/or T2D, with mean differences of -9.1 kg in semaglutide users, -9 kg in liraglutide users, and -11.6 kg in tirzepatide users. No statistically significant weight loss was found with dulaglutide.
• GLP-1 RA use was associated with a reduced risk for surgery (log hazard ratio [logHR], 0.61) and a reduced frequency of surgery events (odds ratio, 0.46).
• A sensitivity analysis found the use of GLP-1 RA was significantly associated with a reduced risk for hospitalization in patients with BMI ≥ 30 (logHR, 0.79) but not in those with BMI < 30.
• The meta-analysis found no significant association between the use of GLP-1 RA and the odds of corticosteroid or advanced therapy initiation or the rate of intestinal obstruction.

IN PRACTICE:

“Our meta-analysis showed that GLP-1 RA significantly reduce weight and reduce risks of hospitalizations and surgery in patients with IBD,” the authors wrote.

SOURCE:

This study, led by Ahmed Bayoumy, MD, MPH, Amsterdam University Medical Center, Amsterdam, Netherlands, was published online in Journal of Crohn’s and Colitis.

LIMITATIONS:

The included studies were heterogeneous in design, population characteristics, and reported outcomes, making it challenging to draw consistent conclusions. Most studies were observational or retrospective, introducing potential unmeasured biases and limiting causal inferences. Additionally, many studies had missing data, lacked reporting on clinical outcomes, scores, or BMI or visceral adiposity, and often did not provide data on side effects. 

DISCLOSURES:

The study received no financial support. Several authors reported having financial relationships with pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.