The Impact of GLP-1RA Use in Patients with IBD, with Priya Sehgal, MD, MPH

A pair of studies at Digestive Disease Week (DDW) 2024 evaluated the clinical impact and safety of glucagon-like peptide-1 (GLP-1) agonists on inflammatory biomarkers in patients with inflammatory bowel disease (IBD).

In an interview with HCPLive, Priya Sehgal, MD, an IBD fellow at the University of Pennsylvania, described the prevalent effect of obesity on IBD management, leading to greater inflammation and decreased rates of endoscopic remission in the disease.

“Because obesity has been associated with a more severe disease phenotype in IBD and now that we do have the increased use of GLP-1 agonists, we decided to look at a retrospective way IBD patients who are prescribed a GLP-1 agonist for obesity, diabetes, or the off-label use of MAFLD,” Sehgal told HCPLive.

The prevalence of obesity is increasing among people with IBD, including Crohn’s disease and ulcerative colitis. Some reported data suggest approximately 15 to 40% of IBD patients experience obesity. As obesity has been linked to more severe disease activity, anti-obesity medications, such as GLP-1 agonists, could be a novel treatment strategy for IBD.

The first retrospective, cohort study examined the safety and clinical effectiveness of GLP-1 agonists for obesity management in a population with IBD. Adults with IBD prescribed a GLP-1 agonist for ≥3 months between 2017 and 2023 were examined for the percentage change in weight after 12 to 24 weeks of therapy.

Among more than 200 patients who started on GLP-1 agonists, approximately 10% experienced adverse events, most commonly nausea and vomiting or diarrhea. As a result, most (92%) patients who experienced adverse events required cessation of GLP-1 agonist therapy. Notably, no cessation was needed due to IBD flare, and no life-threatening events were identified in the analysis.

The second, retrospective cohort study assessed the effect of GLP-1 agonists on inflammatory biomarkers in IBD, including non-cardiac C-reactive protein (CRP) and fecal calprotectin. These biomarkers of adults with IBD were recorded at baseline and compared with the levels at weeks 12 and 24 after medication use.

Results showed GLP-1 agonist therapy reduced mean body weight from baseline in patients with Crohn’s and IBD, with a statistically significant reduction observed in C-reactive protein (P = .04), and a decline in fecal calprotectin, which was not statistically significant (P = .06).

“It may be that these anti-obesity medications are a useful adjunct therapy to our biologic or small-molecule targeted therapies,” Sehgal told HCPLive. “But I think the future should hold some kind of prospective study with these medications in the IBD population, and then a longitudinal follow-up of outcomes, primarily on endoscopic data and long-term remission rates.”

Disclosures: Sehgal reports no disclosures.

References

1. _{Sehgal P, Lichtenstein GR, Khanna T, Profka K, Pickett-Blakely O, Nandi N, Hossain FR, Bewtra M, Lewis JD, Aberra F. Impact of GLP1 Agonists on Inflammatory Biomarkers in Patients with Inflammatory Bowel Disease. ePoster presented at Digestive Disease Week 2024, May 18 - 21, 2024.}
2. _{Sehgal P, Lichtenstein GR, Khanna T, Profka K, Pickett-Blakely O, Nandi N, Hossain FR, Bewtra M, Lewis JD, Aberra F. Safety and Clinical Effectiveness of GLP1 Agonists in Inflammatory Bowel Disease Patients. ePoster presented at Digestive Disease Week 2024, May 18 - 21, 2024.}