GLP-1s Boost IBD Outcomes in Patients With T2D and Obesity

TOPLINE:

The use of glucagon-like peptide 1 (GLP-1) receptor agonists is associated with a reduced risk for poor inflammatory bowel disease (IBD)–related outcomes in patients with both IBD and type 2 diabetes (T2D), specifically in those with obesity.

METHODOLOGY:

• The growing use of GLP-1s for T2D and obesity necessitates a better understanding of their effect on patients with IBD.
• Researchers evaluated 3737 patients with T2D and IBD (50.4% with ulcerative colitis [UC]) from an Israeli nationwide cohort (data from 2005 through June 2021) to investigate the association between the use of GLP-1s and IBD outcomes.
• A total of 633 patients (median age at IBD diagnosis, 54 years; 48.3% men) were treated using GLP-1s, while the remaining 3104 patients (median age at IBD diagnosis, 60 years; 53.6% men) were not.
• The primary outcome was poor IBD-related outcomes, defined as a composite of steroid dependency, IBD treatment escalation, IBD-related hospitalization, abdominal or perianal surgery, or death.
• Each component of the composite outcome was also evaluated individually as a secondary outcome in all the patients with IBD and separately for those with UC and Crohn’s disease (CD). A subgroup analysis compared outcomes between patients with obesity (body mass index [BMI] ≥ 30) and those without obesity (BMI

TAKEAWAY:

• The use of GLP-1s was associated with a reduced risk for composite adverse disease outcomes in patients with IBD (adjusted hazard ratio [aHR], 0.74).
• The reduced risk for composite adverse outcomes was observed both in patients with UC (aHR, 0.71) and in those with CD (aHR, 0.78).
• Among the secondary outcomes, the use of GLP-1s was associated with a reduced risk for hospitalization in patients with IBD (aHR, 0.74) and in those with UC (aHR, 0.63) but not in patients with CD.
• In patients with obesity, the use of GLP-1s was associated with a reduced risk for adverse composite IBD outcomes of 39% in the full cohort of patients with IBD, 37% in the UC group, and 40% in the CD group. However, these benefits were not observed in patients without obesity.

IN PRACTICE:

“As the role of GLP-1 analogs unveils for other obesity-associated indications, obesity-associated IBD might be another potential target for this potent therapy,” the authors wrote.

SOURCE:

This study, led by Yuri Gorelik, MD, MPH, Rambam Health Care Campus, Haifa, Israel, was published online in Journal of Crohn’s and Colitis.

LIMITATIONS:

The patient database lacked information on disease location and endoscopic findings. The study cohort was relatively older, necessitating further research to support these findings in younger individuals. Information on medication adherence was lacking.

DISCLOSURES:

This study was partially supported by the Leona M. and Harry B. Helmsley Charitable Trust. None of the authors reported relevant conflicts of interest.

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