Using GLP-1 Receptor Agonists in Patients with Inflammatory Bowel Disease: A Systematic Review and Single-Arm Meta-Analysis

Abstract

INTRODUCTION: This study aimed to investigate the effects of GLP-1 receptor agonists (GLP-1 RAs) on weight, metabolic, and inflammatory bowel disease (IBD) activity parameters in patients with IBD. METHODS: We conducted a systematic search for studies using GLP-1 RAs in IBD patients. The primary outcomes included weight (body mass index, total body weight, total weight loss percentage [TWL%], and >5 and >10 weight loss [WL]) and metabolic parameters (lipid panel and glycated hemoglobin [HbA1c]), while IBD-activity parameters and adverse events were secondary outcomes. RESULTS: Ten studies were included (n = 7,831). Weight parameters showed reductions, with a TWL% of -7.55% (95% confidence interval [CI]: -3.99 to -11.12), with 60% achieving WL >5% (95% CI: 53 to 67) and 40% achieving WL >10% (95% CI: 33 to 47). Metabolic parameters showed improved and stabilized levels, of which LDL decreased from 94.96 mg/dL (95% CI: 79.91 to 110.00) to 90.45 mg/dL (95% CI: 81.58 to 99.33), and HbA1c, in diabetics, from 7.11% (95% CI: 6.62 to 7.59) to 6.76% (95% CI: 6.35 to 7.16). GLP-1 RAs seem not to exacerbate IBD activity, with improved fecal calprotectin from 289.46 μg/g (95% CI: 62.88 to 516.04) to 210.59 μg/g (95% CI: 75.45 to 345.73), with 11% and 6% requiring IV steroids and advanced therapy, respectively. Adverse events occurred at lower rates, with nausea/vomiting being the most common. CONCLUSION: Our findings suggest that GLP-1 RAs may be promising for reducing weight and improving metabolic parameters without exacerbating activity, and may be a safe option for IBD patients. However, larger randomized controlled trials are needed to assess causal inference and long-term effects.