GLP-1 Receptor Agonists Confer No Increased Rates of IBD Exacerbation Among Patients With IBD

🎖️ Top 10% JournalOct 22, 2024Inflammatory bowel diseases

GLP-1 Receptor Agonists Are Not Linked to More Flare-Ups in Patients with Inflammatory Bowel Disease

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Abstract

In a cohort of 224 patients with inflammatory bowel disease (IBD), there was a significant decrease in median BMI from 33.5 to 31.6 kg/m2 following GLP-1 receptor agonist initiation.

No change was observed in rates of IBD exacerbation, hospitalization, corticosteroid prescriptions, or medication escalations in the 12 months after starting GLP-1 receptor agonists.
The demographic characteristics of the cohort included a median age of 54 years, with 63% being female and 77% White.
Rates of BMI decrease in IBD patients were comparable to those in matched non-IBD controls.
GLP-1 receptor agonists may be effective for weight loss in patients with IBD.

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BACKGROUND: In patients with inflammatory bowel disease (IBD), multimorbidity with obesity and type 2 diabetes is common and increasing. Glucagon-like peptide 1 (GLP-1) receptor agonists are increasingly being prescribed for patients with IBD, yet their impact on patients with IBD is largely unknown. We aimed to assess the impact of GLP-1 receptor agonists on the course of IBD.

METHODS: We identified all IBD patients prescribed GLP-1 receptor agonists at a large academic healthcare network between 2009 and 2023. We analyzed demographics and IBD characteristics in the year pre- and post-GLP-1 receptor agonist prescription and matched them to non-IBD controls. Our primary outcome was IBD exacerbation in the year following GLP-1 receptor agonist initiation, measured as a composite of IBD-related hospitalization, corticosteroid prescription, medication escalation or changes, or IBD-related surgery. Secondary outcomes included change in metabolic risk factors.

RESULTS: Overall, 224 patients met inclusion criteria. At GLP-1 receptor agonist initiation, the median age was 54 years, 63% were female, 77% were White, and median BMI was 33.2 kg/m2. Compared to the 12-month period prior to GLP-1 receptor agonist initiation, in the 12 months post-GLP-1 receptor agonist initiation, there was no change in rates of IBD exacerbation, IBD-related hospitalization, steroids prescription, medication escalation or changes, or IBD-related surgery. There was a significant decrease in BMI in the year following GLP-1 receptor agonist initiation (median BMI 33.5 vs 31.6 kg/m2, P < .01), with rates of decrease comparable to non-IBD matched controls.

CONCLUSIONS: In patients with IBD, GLP-1 receptor agonists are effective for weight loss and associated with few episodes of disease exacerbation.

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