GLP-1RA treatment for T2DM may lower risk of surgery in inflammatory bowel disease

Use of glucagon-like peptide-1 receptor agonist (GLP-1RA) appears to reduce the risk of inflammatory bowel disease (IBD)-related surgery in patients with type 2 diabetes mellitus (T2DM) and concomitant ulcerative colitis (UC) or Crohn’s disease (CD), according to a retrospective study.

For the study, researchers used data from the TriNetX database and looked at patients with UC or CD and T2DM who were receiving treatment with a GLP-1RA or other glucose-lowering drugs (control). Propensity score matching was performed based on demographics, comorbid conditions, BMI, laboratory values, HbA1c, and IBD medications including steroids.

The analysis included 1,130 patients in the UC GLP-1RA cohort (mean age 58.9 years, 56.3 percent female, 70.2 percent White, 57.2 percent with obesity) and 1,140 patients in the CD GLP-1RA cohort (mean age 56.7 years, 61.9 percent female, 73.6 percent White, 56.2 percent with obesity).

Cox proportional hazards regression analyses in the UC cohort showed that the GLP-1RA and control groups did not significantly differ in terms of the risk of intravenous steroid use (adjusted hazard ratio [aHR], 1.21, 95 percent confidence interval [CI], 0.92–1.59). However, GLP-1RA users had a lower risk of colectomy than controls (aHR, 0.37, 95 percent CI, 0.14–0.97).

Results were similar in the CD cohort, where the risk of intravenous steroid use did not significantly differ between the GLP-1RA and control groups (aHR, 1.04, 95 percent CI, 0.80–1.34). Likewise, GLP-1RA use was associated with a lower risk of surgery (aHR, 0.55, 95 percent CI, 0.36–0.84).

There was no difference in the risk of oral steroid use or advanced therapy initiation between the GLP-1RA and control groups in the UC and CD cohorts.