Glucagon-like peptide-1 receptor agonists associated with improved clinical outcomes in patients with inflammatory bowel disease: a retrospective cohort study

Oct 27, 2025Naunyn-Schmiedeberg's archives of pharmacology

Glucagon-like peptide-1 receptor drugs linked to better health outcomes in people with inflammatory bowel disease

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Abstract

Exposure to GLP-1 receptor agonists is associated with a significantly lower 5-year mortality rate of 8.05% compared to 10.03% in patients not exposed.

Patients with IBD exposed to GLP-1 receptor agonists had a hazard ratio of 0.65 for mortality, indicating a potential protective effect.
Rates of IBD-related surgeries were also lower in the GLP-1 RAs group, with a hazard ratio of 0.53.
The incidence of complications related to IBD was reduced, with a hazard ratio of 0.81 for those receiving GLP-1 RAs.
Fewer overall healthcare encounters were observed in patients using GLP-1 RAs, suggesting potential reductions in healthcare utilization.
Differences in corticosteroid and advanced biologic medication use were noted, but these findings did not persist in subgroup analyses.

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Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated anti-inflammatory effects in preclinical models of inflammatory bowel disease (IBD), yet clinical data remain limited. This study aimed to assess the association between GLP-1 RAs exposure and disease-related outcomes, treatment patterns, and healthcare utilization in patients with IBD. We conducted a retrospective, propensity score-matched cohort study using data from the TriNetX Analytics Research Network. Adults diagnosed with Crohn's disease or ulcerative colitis between 2006 and 2022 were matched 1:1 based on GLP-1 RAs exposure. Patients with confounding comorbidities were excluded. Key outcomes included 5-year mortality, IBD-related surgeries and complications, medication use, and healthcare utilization. A total of 11,016 matched IBD patients were included (GLP-1 RAs: n = 5508; no GLP-1 RAs: n = 5508). Exposure to GLP-1 RAs was associated with a significantly lower 5-year mortality rate (8.05% vs 10.03%, hazard ratio [HR] 0.65, 95% confidence interval [CI] 0.54-0.78, p < 0.0001). Rates of IBD-related surgeries (HR 0.53, 95% CI 0.39-0.72) and complications (HR 0.81, 95% CI 0.70-0.93) were also reduced. Moreover, patients in the GLP-1 RAs group experienced fewer overall healthcare encounters (χ = 136.52, p < 0.0001). Significant differences were observed in corticosteroid (p < 0.0001) and advanced biologic use (p < 0.0001), although rank biserial correlation was small (0.04 and - 0.11, respectively), and findings on medication use did not persist in subgroup analyses of ulcerative colitis and Crohn's disease patients. Our findings suggest a potential disease-modifying effect of GLP-1 RAs beyond glycemic control, especially in reducing mortality, complications, surgeries, and healthcare use. However, the clinical relevance of reduced medication use warrants further investigation through prospective trials. 2

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Glucagon-like peptide-1 receptor agonists associated with improved clinical outcomes in patients with inflammatory bowel disease: a retrospective cohort study

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