GLP-1 Benefits For People With Ulcerative Colitis and Obesity

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Results from a retrospective cohort study show lower all-cause mortality and fewer hospitalizations and intestinal complications among those treated with semaglutide, tirzepatide and other GLP-1s.

Glucagon-like peptide 1 (GLP-1) receptor agonists are known to effectively manage type 2 diabetes and promote weight loss. A study presented last month at the American College of Gastroenterology (ACG) 2024 Annual Scientific Meeting in Philadelphia found these treatments could have additional benefits for people with obesity and ulcerative colitis.

Luis M. Nieto, M.D.

Luis M. Nieto, M.D.

Approximately 15% to 40% of people with inflammatory bowel disease, including ulcerative colitis and Crohn’s disease, have obesity, and GLP-1s have been shown to reduce inflammation in ulcerative colitis animal models. To evaluate the effects of GLP-1s on patients with obesity and ulcerative colitis, Luis M. Nieto, M.D., from Emory University School of Medicine in Atlanta, Georgia, and colleagues conducted a retrospective cohort study using data derived from the TriNetX platform, a large, global, real-world database.

The study included 2,204 adults with obesity and ulcerative colitis who were taking GLP-1s between January 1, 2019, and December 31, 2023. The group was propensity-matched with 2,204 individuals with ulcerative colitis and obesity who did not take GLP-1s. The GLP-1s included in the study were semaglutide (Ozempic, Wegovy, Rybelsus), liraglutide (Saxenda, Victoza), dulaglutide (Trulicity), and tirzepatide (Mounjaro, Zepbound).

The study endpoints were 5-year incidence of all-cause mortality, hospitalization, colorectal cancer and corticosteroid use. They also included intestinal complications, such as intestinal bleeding, perforation, or obstruction, and nonintestinal complications, such as liver, musculoskeletal, eye and skin issues.

The researchers found that patients who took GLP-1s had significantly lower odds of all-cause mortality, hospitalization, intestinal complications and corticosteroid use versus those who did not take GLP-1s. The GLP-1 group also had lower odds of hepatobiliary complications, such as gallstones and bile duct carcinoma, compared with the non-GLP-1 group. No differences were observed in the incidence of other nonintestinal complications or colorectal cancer.

Nieto and his colleagues concluded that GLP-1s are associated with lower odds of mortality, hospitalization, corticosteroid use, and certain complications in patients with ulcerative colitis and obesity. They recommend additional prospective studies to further investigate these results.

The presentation’s ePoster can be viewed on the ACG 2024 ePoster Hall website:

P0840 – GLP-1 Agonist Use is Associated With Lower Complications and Mortality in Patients With Ulcerative Colitis and Obesity: A National Database Analysis

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