P4331 - Impact of GLP-1 Agonists on the Severity of Inflammatory Bowel Disease

Sarah Coats, MD¹, Scott R. Anderson, MD², Malek Ayoub, MD², Parakkal Deepak, MBBS, MS³, Scott McHenry, MD, MSc^1
1Washington University School of Medicine in St. Louis / Barnes-Jewish Hospital, St. Louis, MO; ²Washington University School of Medicine in St. Louis, St. Louis, MO; ³Washington University in St. Louis, St. Louis, MO

Introduction: The use of GLP-1 agonists has gained significant popularity for the treatment of type 2 diabetes and obesity, particularly in patients with co-morbid conditions. Beyond their metabolic benefits, GLP-1 agonists are postulated to possess anti-inflammatory properties. However, this area needs more investigation.

Methods: A retrospective chart review was conducted at a tertiary care center on patients diagnosed with inflammatory bowel disease (IBD) who were prescribed any GLP-1 agonist (semaglutide, liraglutide, dulaglutide, exenatide, or tirzepatide) for a minimum duration of 30 days between 2014 and 2024. The primary outcomes evaluated to assess IBD disease severity included the number of IBD-related hospitalizations, clinical disease severity as measured by the Harvey-Bradshaw Index (HBI) for Crohn's Disease (CD) and the Mayo Score/Disease Activity Index (DAI) for Ulcerative Colitis (UC), endoscopic disease activity scores using the Simple Endoscopic Score for Crohn's Disease (SES-CD) and the Mayo Endoscopic Score for Ulcerative Colitis, and the inflammatory marker C-reactive protein (CRP). The Wilcoxon signed-rank test was utilized to compare IBD severity within the year preceding and following the initiation of GLP-1 agonist therapy.

Results: A total of 120 IBD patients (61 CD, 59 UC) who were on GLP-1 agonists for at least 30 days were identified. The mean duration of GLP-1 therapy was 28.9 months. A significant reduction in the average CRP levels was observed one year after starting therapy compared to one year prior (12.92 vs 6.38 mg/dL, P=0.005). However, there was no statistically significant difference in the number of IBD-related hospitalizations. Additionally, no significant changes were observed in clinical rating scores, or endoscopic scores (Table 1).

Discussion: The study observed a significant reduction in the CRP levels one year after the initiation of GLP-1 agonist therapy, suggesting a potential anti-inflammatory effect. Despite the improvement in CRP levels, no significant changes were detected in other key clinical outcomes. These findings highlight that while GLP-1 agonists may contribute to a reduction in systemic inflammation, as reflected by lower CRP levels, their effect on clinical and endoscopic disease activity in IBD patients requires further investigation.


Disclosures:


Sarah Coats, MD¹, Scott R. Anderson, MD², Malek Ayoub, MD², Parakkal Deepak, MBBS, MS³, Scott McHenry, MD, MSc¹. P4331 - Impact of GLP-1 Agonists on the Severity of Inflammatory Bowel Disease, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.