P0855 - Weight Loss and Safety of Glucagon-like Peptide-1 Agonists in Inflammatory Bowel Disease Patients

Scott R. Anderson, MD¹, Sarah Coats, MD², Malek Ayoub, MD¹, Scott McHenry, MD, MSc², Parakkal Deepak, MBBS, MS^3
1Washington University School of Medicine in St. Louis, St. Louis, MO; ²Washington University School of Medicine in St. Louis / Barnes-Jewish Hospital, St. Louis, MO; ³Washington University in St. Louis, St. Louis, MO

Introduction: Obesity is an increasingly worrisome global health issue. Glucagon-like peptide-1 (GLP-1) agonists have gained popularity for their weight loss and glycemic benefits. There is a scarcity of literature on the safety of these agents in inflammatory bowel disease (IBD) patients. This study aims to examine the frequency of side effects as well as weight loss benefit of these agents in IBD patients.

Methods: A retrospective cohort study in a tertiary care IBD center was conducted on patients with a confirmed diagnosis of IBD, a prescription of a GLP-1 agonist (dulaglutide, exenatide, liraglutide, semaglutide, or tirzepatide) for at least 30 days between 2014 and 2024, and documentation of a baseline weight in the electronic medical record either 28 days prior to, on the day of, or 28 days after the initiation of GLP-1 agonist. Our primary outcomes include percent weight loss from start of GLP-1 agonist to 1 year post-initiation and adverse effects and reasons for discontinuation of GLP-1 agonists.

Results: 110 patients met the inclusion criteria. Patients demonstrated weight loss with GLP-1 therapy with an average weight reduction of 3.9% at the 1-year interval. 14 (12.7%) patients experienced GI side effects that led to discontinuation of GLP-1 therapy, including abdominal pain (N=2, 1.8%), bloating (N=1, 0.9%), constipation (N=4, 3.6%), diarrhea (N=4, 3.6%), gastroparesis (N=1, 0.9%), nausea (N=4, 3.6%), IBD flare (N=1, 0.9%), and pancreatitis (N=1, 0.9%). Other reasons for discontinuation included cost (N=29, 26.4%), switching to an alternative agent (N=29, 26.4%), hypoglycemia (N=2, 1.8%), injection site reaction (N=2, 1.8%), and unknown (N=21, 19.1%).

Discussion: GLP-1 agonists appear to be well-tolerated in inflammatory bowel disease patients. Compared to other studies, the side effect profile is similar. Patients lost weight; however, the percent weight loss was less than prior randomized controlled trials. This is likely due to real world factors such as patients not taking GLP-1 therapy for 1 year continuously and costs associated with the medication leading to discontinuation. Larger prospective studies are needed to verify study findings.


Disclosures:


Scott R. Anderson, MD¹, Sarah Coats, MD², Malek Ayoub, MD¹, Scott McHenry, MD, MSc², Parakkal Deepak, MBBS, MS³. P0855 - Weight Loss and Safety of Glucagon-like Peptide-1 Agonists in Inflammatory Bowel Disease Patients, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.