Systematic Review: Efficacy, Safety and Metabolic Outcomes of GLP‐1 Receptor Agonists in Inflammatory Bowel Disease

🥉 Top 5% JournalNov 30, 2025Alimentary pharmacology & therapeutics

Effectiveness, Safety, and Metabolic Impact of GLP-1 Drugs in Inflammatory Bowel Disease

AI simplified

GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗OA ↗

Abstract

14 studies were evaluated to assess the effects of glucagon-like peptide-1 receptor agonists on patients with inflammatory bowel disease.

Significant reductions in body weight, BMI, or percent weight loss were reported in 10 studies.
Four studies showed improvements in metabolic markers, including decreased haemoglobin A1c and favourable lipid changes.
GLP-1 receptor agonist use was not associated with increased exacerbations of inflammatory bowel disease.
Data from large registries indicated reduced risks of corticosteroid use, hospitalisation, and surgery among users of GLP-1 receptor agonists.
Adverse events were primarily gastrointestinal, aligning with findings in non-IBD populations.

AI simplified

BACKGROUND: Obesity and metabolic disease are increasingly prevalent in patients with inflammatory bowel disease (IBD) and can influence disease activity and treatment outcomes. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are effective for weight loss and metabolic control, yet their safety and effects in IBD remain uncertain as patients with IBD have been excluded from pivotal trials.

AIMS: To systematically evaluate the weight-related, metabolic, IBD-specific, and safety outcomes of GLP-1 receptor agonists in adults with IBD.

METHODS: We conducted a systematic review according to PRISMA guidelines (PROSPERO CRD42025628850). We searched MEDLINE, Embase, Cochrane Library and ClinicalTrials.gov to 9 September 2025 for studies evaluating GLP-1 RAs in adults with IBD. Primary outcomes were weight-related measures. Secondary outcomes included metabolic parameters, IBD activity, and safety. Risk of bias was assessed using Joanna Briggs Institute (JBI) checklists.

RESULTS: We included 14 studies of which 13 were retrospective cohort studies. Ten reported significant reductions in body weight, BMI, or percent weight loss. Four demonstrated improvements in metabolic markers, including decreased haemoglobin A1c and favourable lipid changes. Across multiple datasets, GLP-1 RA use was not associated with increased IBD exacerbations. Several large registries reported reduced risks of corticosteroid use, hospitalisation and surgery among GLP-1 RA users. Adverse events were primarily gastrointestinal, consistent with non-IBD populations.

CONCLUSION: GLP-1 RAs appear to be well tolerated in patients with IBD, with observational evidence suggesting potential associations with improved weight, metabolic, and disease-related outcomes. Prospective, IBD-specific studies are required to confirm safety, clarify mechanisms, and define optimal patient selection.

Key numbers

10 of 14 studies

Weight Loss Rate

Studies reporting significant reductions in body weight, BMI, or percent weight loss.

−0.76

Improved HbA1c Levels

Mean change in HbA1c among IBD patients on tirzepatide.

HR 0.66

Reduced Hospitalization Risk

Adjusted hazard ratio for hospitalization among GLP-1 RA users vs. non-users.

Full Text

We can’t show the full text here under this license. Use the link below to read it at the source.

View full text ↗

Abstract

Key numbers

Full Text

Related papers