Use of glucagon-like peptide-1 receptor agonists for type 2 diabetes mellitus and outcomes of inflammatory bowel disease

BackgroundGlucagon-like peptide-1 receptor agonists (GLP-1RA) show anti-inflammatory properties.AimTo evaluate their clinical impact on inflammatory bowel disease (IBD) outcomes.MethodsRetrospective cohort study utilising the TriNetX database comparing IBD-specific outcomes in patients with ulcerative colitis (UC) or Crohn's disease (CD) and type 2 diabetes mellitus (T2DM) on GLP-1RA compared to oral hypoglycaemic agents. The primary outcome was hospitalisation requiring intravenous steroids and IBD-related surgery within 3 years. We performed 1:1 propensity score matching (PSM) for demographics, co-morbid conditions, BMI, laboratory values, HbA1c, and IBD medications including steroids.ResultsWe identified 1130 patients in the UC GLP-1RA cohort (mean age: 58.9 +/- 11.6 years, 56.3% female, 70.2% White, 57.2% with obesity) and 1140 patients in the CD GLP-1RA cohort (mean age: 56.7 +/- 11.5, 61.9% female, 73.6% White, 56.2% with obesity). After PSM, there was no difference in the risk of intravenous steroid use (aHR: 1.21, 95% CI: 0.92-1.59) but a lower risk of colectomy (aHR: 0.37, 95% CI: 0.14-0.97) between the UC GLP-1RA and control cohort. There was no difference in the risk of intravenous steroid use (aHR: 1.04, 95% CI: 0.80-1.34) but a lower risk of surgery (aHR: 0.55, 95% CI: 0.36-0.84) between the CD GLP-1RA and CD control cohort. There was no difference in the risk of oral steroid use or advanced therapy initiation in the UC and CD GLP-1RA than control cohorts.ConclusionsWe found an association between lower risk of IBD-related surgery and GLP-1RA use for T2DM in patients with UC or CD. GLP-1RA use for T2DM is associated with lower risk of surgery compared to oral hypoglycemic agents in patients with UC and CD. There was no difference in the risk of hospitalisation requiring intravenous steroids with GLP-1RA use compared to oral hypoglycemic agents.image