P4388 - Glucagon-Like Peptide-1 Receptor Agonists is Associated with Lower Prevalence of Inflammatory Bowel Diseases and Its associated Complications in Diabetic Patients: Global Healthcare Database Study

Mengdan Xie, MD¹, Yan Sun, MD¹, Gengqing Song, MD, PhD^2
1Case Western Reserve University / MetroHealth, Cleveland, OH; ²Metrohealth Medical Center, Cleveland, OH

Introduction: Study showed glucagon-like peptide-1 receptor agonists (GLP-1RAs) may improve inflammatory bowel disease (IBD) by reducing colonic inflammation through modulation of gut microbiota and immune cell function. This study aims to demonstrate the protective benefits of GLP-1RAs in IBD within a global patient cohort.

Methods: A population-based study was conducted using the TriNetX network. The GLP-1RAs group included adult patients with type 2 diabetes mellitus(T2DM) using GLP-1RAs, with sodium-glucose co-transporter 2 inhibitors (SGLT2i) users as controls. We excluded patients with gastrointestinal (GI) malignancy or major GI surgery. Patients with newly-onset IBD, its complications, and IBD-related extraintestinal manifestations after initiation of GLP-1RAs or SGLT2i were identified. Propensity score matching was performed to reduce selection bias.

Results: A total of 583,646 patients were included in the GLP-1RAs and control groups after matching. Compared to controls, the GLP-1RAs group showed significantly lower prevalence of newly diagnosed IBD (OR 0.59, 95%CI 0.57-0.61, p< 0.001), ulcerative colitis (UC) (0.75, 0.69-0.83, p< 0.001), and Crohn’s disease (CD) (0.6, 0.53-0.68, p< 0.001). The prevalence of UC complications (0.57, 0.52-0.64, p< 0.001), CD complications (0.82, 0.69-0.98, p< 0.001), C. difficile infection (0.47, 0.43-0.50, p< 0.001), and colorectal cancer (0.44, 0.41-0.49, p< 0.001) were significantly lower in the GLP-1RAs group. However, the lower prevalence of colorectal cancer was not solely due to lower IBD prevalence. Further analysis revealed similar prevalence of biologics use in both groups (1.02, 0.93-1.11, p=0.709), but a significantly lower prevalence of GI surgery (0.84, 0.82-0.86, p< 0.001), especially colectomy (0.47, 0.42-0.53, p< 0.001) in the GLP-1RAs group.
For IBD-related extraintestinal manifestations, osteoporosis (0.67, 0.66-0.69, p< 0.001), skin manifestations (erythema nodosum, pyoderma gangrenosum) (0.47, 0.36-0.61, p< 0.001), eye manifestations (uveitis, episcleritis, scleritis) (0.6, 0.49-0.72, p< 0.001), and IBD-related arthritis (0.67, 0.66-0.68, p< 0.001) were less prevalent in the GLP-1RAs group. No significant differences were found in the prevalence of primary sclerosing cholangitis or vitamin D deficiency between the groups.

Discussion: GLP-1RAs are associated with a lower prevalence of IBD and its complications, suggesting potential therapeutic benefits for IBD patients with T2DM and obesity.



Disclosures:


Mengdan Xie, MD¹, Yan Sun, MD¹, Gengqing Song, MD, PhD². P4388 - Glucagon-Like Peptide-1 Receptor Agonists is Associated with Lower Prevalence of Inflammatory Bowel Diseases and Its associated Complications in Diabetic Patients: Global Healthcare Database Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.