Use of glucagon‐like peptide‐1 receptor agonists for type 2 diabetes mellitus and outcomes of inflammatory bowel disease

Jun 28, 2024Alimentary pharmacology & therapeutics

Use of diabetes drugs targeting GLP-1 receptors and their effects on inflammatory bowel disease

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Abstract

In a cohort of 1130 patients with ulcerative colitis, GLP-1 receptor agonist use is associated with a lower risk of colectomy compared to standard treatments.

There was no difference in the risk of intravenous steroid use between patients on GLP-1RA and those on oral hypoglycaemic agents for ulcerative colitis.
Patients with ulcerative colitis on GLP-1RA had a lower risk of colectomy compared to those receiving standard treatment.
For Crohn's disease, GLP-1RA use was also associated with a lower risk of surgery compared to control patients.
No significant differences were observed in the risk of oral steroid use or advanced therapy initiation between the GLP-1RA groups and control cohorts.

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BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RA) show anti-inflammatory properties.

AIM: To evaluate their clinical impact on inflammatory bowel disease (IBD) outcomes.

METHODS: Retrospective cohort study utilising the TriNetX database comparing IBD-specific outcomes in patients with ulcerative colitis (UC) or Crohn's disease (CD) and type 2 diabetes mellitus (T2DM) on GLP-1RA compared to oral hypoglycaemic agents. The primary outcome was hospitalisation requiring intravenous steroids and IBD-related surgery within 3 years. We performed 1:1 propensity score matching (PSM) for demographics, co-morbid conditions, BMI, laboratory values, HbA1c, and IBD medications including steroids.

RESULTS: We identified 1130 patients in the UC GLP-1RA cohort (mean age: 58.9 ± 11.6 years, 56.3% female, 70.2% White, 57.2% with obesity) and 1140 patients in the CD GLP-1RA cohort (mean age: 56.7 ± 11.5, 61.9% female, 73.6% White, 56.2% with obesity). After PSM, there was no difference in the risk of intravenous steroid use (aHR: 1.21, 95% CI: 0.92-1.59) but a lower risk of colectomy (aHR: 0.37, 95% CI: 0.14-0.97) between the UC GLP-1RA and control cohort. There was no difference in the risk of intravenous steroid use (aHR: 1.04, 95% CI: 0.80-1.34) but a lower risk of surgery (aHR: 0.55, 95% CI: 0.36-0.84) between the CD GLP-1RA and CD control cohort. There was no difference in the risk of oral steroid use or advanced therapy initiation in the UC and CD GLP-1RA than control cohorts.

CONCLUSIONS: We found an association between lower risk of IBD-related surgery and GLP-1RA use for T2DM in patients with UC or CD.

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Use of glucagon‐like peptide‐1 receptor agonists for type 2 diabetes mellitus and outcomes of inflammatory bowel disease

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