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

Luis M.. Nieto, MD¹, Sharon Narvaez, MD², Do Han Kim, MD³, Donghyun Ko, MD⁴, Saurabh Chawla, MD¹, Kenneth Vega, MD, FACG⁵, Laura Davisson, MD⁶, Jami A. Kinnucan, MD, FACG^7
1Emory University School of Medicine, Atlanta, GA; ²Universidad de Guayaquil, School of Medicine, Atlanta, GA; ³Mount Sinai Morningside and West, Icahn School of Medicine at Mount Sinai, New York, NY; ⁴Yale-New Haven Health/Bridgeport Hospital, Bridgeport, CT; ⁵Medical College of Georgia at Augusta University, Augusta, GA; ⁶West Virginia University, Morgantown, WV; ⁷Mayo Clinic, Jacksonville, FL

Introduction: The prevalence of obesity in patients with inflammatory bowel disease (IBD) has been reported to be approximately 15% to 40 %. GLP-1 receptor agonists (GLP-1 RAs), a medication commonly used to treat diabetes and obesity, have shown promising results in reducing inflammation in animal models of colitis. Therefore, we aim to evaluate the outcomes of patients with ulcerative colitis (UC) and obesity taking GLP-1 RAs.

Methods: We performed a retrospective cohort study utilizing large population-based data from the TriNetX platform. We identified patients with obesity (BMI of 30 or greater) and UC who received GLP-1 RAs (semaglutide, liraglutide, dulaglutide and tirzepatide) between January 1, 2019, and December 31, 2023. This cohort of patients was matched with UC patients who did not receive GLP-1 RAs according to age, demographics, comorbidities, and medication by using 1:1 propensity matching. The endpoints were 5-year incidence of all-cause mortality, hospitalization, colorectal cancer (CRC), intestinal complications (includes megacolon, perforation, obstruction, bleeding and abscess), corticosteroid use and extraintestinal manifestations (hepatobiliary, musculoskeletal, eye and skin manifestations). Logistic regression was used to estimate Odd Ratios (ORs).

Results: A total of 16,783 adult patients with UC and obesity were identified, 2,301 of these individuals were taking GLP -1 RAs; 2,204 out of 2,301 (mean [SD] age, 58.8 [11.7] years; 1,232 [55.8%] female) were matched with 2,204 individuals (mean [SD] age, 58.5 [14.2] years; 1,240 [56.2%] female) who did not take GLP-1 RAs. The GLP-1 RAs group had significant lower odds of all-cause mortality (ORs, 0.38; 95% Confidence Interval [CI], 0.28-0.53), lower odds of hospitalization (ORs, 0.66; 95% CI, 0.52-0.85), lower odds of intestinal complications (ORs, 0.47; 95% CI, 0.34-0.66), lower odds of corticosteroid use (ORs, 0.75; 95% CI, 0.66-0.85), and hepatobiliary manifestations (cholangitis, bile duct carcinoma and cholelithiasis, ORs, 0.38; 95% CI, 0.23-0.63) when compared with the non- GLP -1 RAs group. No differences were found in the incidence of CRC and other extraintestinal manifestations.

Discussion: Patients with UC and obesity who are taking GLP-1 RAs have lower odds of all-cause mortality, hospitalization, intestinal complications, corticosteroid use and hepatobiliary manifestations. Further prospective studies are needed to determine the mechanism for these clinical findings.


Disclosures:


Luis M.. Nieto, MD¹, Sharon Narvaez, MD², Do Han Kim, MD³, Donghyun Ko, MD⁴, Saurabh Chawla, MD¹, Kenneth Vega, MD, FACG⁵, Laura Davisson, MD⁶, Jami A. Kinnucan, MD, FACG⁷. P0840 - GLP-1 Agonist Use is Associated With Lower Complications and Mortality in Patients With Ulcerative Colitis and Obesity: A National Database Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.