S1493 Clinical Effectiveness and Safety of GLP1RA in Patients With IBD

Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1RA) have garnered attention for their anti-inflammatory effects in patients with obesity and diabetes. Their use in inflammatory bowel disease (IBD) is of growing interest. However, the long-term impact of GLP-1RA–induced weight loss in IBD, particularly regarding safety and nutritional status, remains understudied. This study aims to assess weight loss and safety outcomes over a 12-month period in patients with IBD initiated on GLP-1RA therapy. Methods: A retrospective chart review was conducted at a quaternary care center between January 2018 to January 2025 to identify patients with Crohn’s disease (CD) or ulcerative colitis (UC) treated with any GLP-1RA for at least 3 months. Baseline weight (within 6 months pre-initiation of GLP-1RA) was compared to weights at 3-month intervals up to at least 12 months post-initiation. Paired t-tests were used to assess weight changes. Adverse events, including gastrointestinal (GI) symptoms and complications near initiation or dose changes, were recorded. Results: A total of 360 IBD (180 CD and 174 UC) patients on a GLP-1RA were included and semaglutide was the most commonly prescribed GLP-1RA (57%). The sample had a median age of 56 with 64% females and 78% non-Hispanic White. Baseline weights were available for all patients (mean 102.88 kg (±24.62), with 165 having 12-month follow-up data. Statistically significant weight loss was observed at each 3-month interval compared to baseline prior to GLP-1RA initiation: 0–3 months (−3.12 kg), 3–6 months (−5.4 kg ± 10.45), 6–9 months (−7.13 kg ± 12.93), 9–12 months (−8.65 kg ± 13.88), and 12 months (−7.15 kg ± 10.32), all P < 0.0001. Adverse events were absent in 67% of patients with one episode of pancreatitis; reported GI symptoms included nausea/vomiting (13%), diarrhea (6%), and constipation (5.6%). Conclusion: In this study, GLP-1RA use in patients with IBD was associated with significant and sustained weight loss over 12 months, reaching a peak reduction of 8.4% at 9–12 months. Notably, this occurred without clinical concern for malnutrition or sarcopenia. The treatment was well tolerated, with predominantly mild GI side effects. These findings suggest GLP-1RAs may offer a favorable safety profile while supporting potential long-term anti-inflammatory benefits in IBD through weight reduction. Further prospective studies may validate these outcomes by trending inflammatory markers and endoscopic changes.