Glucagon‐Like Peptide‐1 Receptor Agonists Are Associated With Improved Outcomes in Inflammatory Bowel Disease

Background The co‐existence of diabetes and obesity in patients with inflammatory bowel disease (IBD) increases morbidity and mortality associated with IBD, yet it remains unclear how medications used to treat these metabolic disorders affect IBD course. This study examines the impact of glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs), a predominant class of antidiabetic and antiobesity medications, on IBD outcomes. Methods Using TriNetX, a healthcare database comprising over 110 million patients in the United States, we identified cohorts of IBD patients based on their exposure to GLP‐1RA as well as a metformin comparator cohort. Cases were IBD patients on GLP‐1RA, while controls were IBD patients without exposure to GLP‐1RA. The two cohorts were propensity score matched for demographics, comorbidities, and IBD medications. Outcomes of interest were IBD‐related surgeries, inpatient hospitalizations, emergency room (ER) visits, and steroid use within 5 years after the index event of GLP‐1RA use. Chi‐square and t ‐tests were used for significance testing. Results There were 11,559 IBD cases with prior GLP‐1RA exposure and 258,046 IBD controls without prior GLP‐1RA exposure. After propensity score matching, 9596 cases and controls were evenly matched. Compared to controls, IBD patients on GLP‐1RA were less likely to have IBD‐related surgeries (OR 0.36, 95% CI 0.29–0.46), inpatient hospitalizations (OR 0.44, 95% CI 0.41–0.46), ER visits (OR 0.56, 95% CI 0.52–0.59), or steroid use (OR 0.56, 95% CI 0.53–0.60). In matched analyses against metformin, GLP‐1RA exposure was also associated with lower odds across all endpoints. Conclusion Patients with IBD on GLP‐1RA therapy had fewer IBD‐related surgeries, inpatient hospitalizations, ER visits, and steroid use, even when compared to those on metformin. Further research is needed to investigate the role of GLP‐1RA in modulating inflammation in IBD patients.