Glucagon-like peptide 1 receptor agonists may decrease rates of inflammatory bowel disease flares

1. The use of glucagon-like peptide 1 (GLP-1) agonists in patients with inflammatory bowel disease (IBD) was associated with few episodes of disease exacerbation and resulted in a significant decrease in BMI 1 year following initiation. 

Evidence Rating Level: 2 (Good)

Recent evidence has suggested that obesity may be associated with worse outcomes in IBD, such as decreased responsiveness to IBD therapies. GLP-1 agonists are novel agents originally approved for the management of type 2 diabetes mellitus, which have also demonstrated weight-lowering benefits in other patients. However, the safety of GLP-1 agonists in patients with IBD has not been well characterized. This observational study therefore sought to investigate the safety and effectiveness of GLP-1 agonists on weight loss in IBD patients. 224 patients with IBD (median age, 54 years; 36.6% male) who were utilizing GLP-1 receptor agonists were identified from the NYU Langone Health system. The primary outcome of the study was IBD exacerbation 1 year following GLP-1 receptor agonist prescription, while the efficacy of GLP-1 receptor agonists was measured by comparing BMI values between IBD patients and non-IBD controls. At 1 year prior to initiation of GLP-1 receptor agonist therapy, 34.4% of patients had an IBD exacerbation compared to 30.4% 1 year after initiation of GLP-1 receptor agonist. There was no significant difference in the rate of exacerbation before and after initiation of GLP-1 receptor agonist (P = .36). Among IBD patients, there was a significant decrease in BMI 1 year after GLP-1 receptor agonist initiation (median BMI decrease from 33.5-31.6 kg/m2; P = <0.01). A significant change in BMI was also observed in non-IBD patients (median BMI decrease 36.1-34.4 kg/m2, P < .01); however, significant changes were observed in the levels of cholesterol, LDL and HDL among IBD patients which were not observed in controls. Overall, this study found that GLP-1 receptor agonists were not associated with increased rates of disease exacerbation in IBD patients and are effective in decreasing BMI. 

Click to read the study in Inflammatory Bowel Disease

Image: PD

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