S1936 Glucagon Like Peptide 1 Receptor Agonist Use Is Associated With Improved Clinical Outcomes in Inflammatory Bowel Disease

Introduction: Glucagon like peptide 1 receptor agonists (GLP-RA) have anti-inflammatory properties, yet their effect on the clinical course of inflammatory bowel disease (IBD) is unclear. Methods: We conducted a retrospective multicenter cohort study using a national multi-institution database. Adults with Crohn disease or ulcerative colitis receiving a GLP-1 RA (dulaglutide, liraglutide, tirzepatide, or semaglutide) formed the exposure cohort. A one-to-one propensity matched comparator cohort of IBD patients without GLP-1 RA exposure was created (29 203 in each cohort) balancing demographics, comorbidities, and IBD medications. Outcomes within 365 days after index prescription were colectomy, bowel resection, intravenous (IV) steroid use, oral (PO) steroid use, emergency department (ED) visits, and hospitalizations. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated from matched data. Analysis of de-identified data was exempt from institutional review board oversight. Results: Baseline characteristics were well balanced. Mean age was 56.9 ± 13.2 vs 57.6 ± 14.1 years; female sex 18,181 [62.3%] vs 18,146 [62.1%]; White race 21,663 [74.2%] vs 21 562 [73.8%]. Comorbidities and medication class use were similar after matching. During follow up, GLP 1 analog use was associated with lower risks of all escalation outcomes. Colectomy occurred in 48 patients [0.2%] vs 198 [0.7%] (aOR 0.241, 95% CI 0.176 0.331). Bowel resection was 0.015% vs 0.036% (aOR 0.411, 95% CI 0.367 0.460). IV steroid use was 23.7% vs 25.0% (aOR 0.934, 95% CI 0.899 0.969); PO steroid initiation 15.4% vs 18.5% (aOR 0.799, 95% CI 0.766 0.835); ED visits 19.1% vs 23.8% (aOR 0.756, 95% CI 0.727 0.787); and hospitalizations 13.1% vs 23.3% (aOR 0.495, 95% CI 0.474 0.517). Conclusion: In a real-world matched cohort of 58,406 IBD patients, GLP-1 RA use was linked to significantly lower colectomy, bowel resection, corticosteroid use, ED utilization, and hospitalization. Further data are needed from prospective trials to evaluate GLP-1 RA therapy as an adjunct for inflammatory bowel disease.