GLP-1s Reduce Mortality, Complications Among Patients With UC

Patients with ulcerative colitis (UC) and obesity who are taking GLP-1 agonists have lower odds of all-cause mortality, hospitalization, intestinal complications, corticosteroid use, and hepatobiliary manifestations, according to research presented at the American College of Gastroenterology meeting in Philadelphia, Pennsylvania.

Luis M. Nieto, MD, of Emory University in Atlanta, Georgia, on behalf of himself and colleagues, presented a poster on their research into the outcomes of patients with UC and obesity being treated with GLP-1 Ras.

Dr Nieto is a gastroenterology fellow at the Emory University School of Medicine in Atlanta, Georgia.

The investigators performed a retrospective cohort study using data from the large TriNetX platform. They identified patients with obesity, defined as a body mass index (BMI) of 30 or greater and patients with UC who received semaglutide, liraglutide, dulaglutide, and tirzepatide) between January 1, 2019, and December 31, 2023. Using 1:1 propensity matching according to age, demographics, comorbidities, and medication, this cohort was matched with UC patients who did not receive GLP-1 RAs.

The endpoints were 5-year incidence of all-cause mortality, hospitalization, colorectal cancer (CRC); intestinal complications, including megacolon, perforation, obstruction, bleeding, and abscess; corticosteroid use; and extraintestinal manifestations including hepatobiliary, musculoskeletal, eye, and skin manifestations. Logistic regression was used to estimate odd ratios (ORs).

A total of 16,783 adult patients with UC and obesity were identified, of whom 2301 were taking GLP -1 RAs; 2204 out of 2301 (mean [SD] age, 58.8 [11.7] years; 1232 [55.8%] female) were matched with 2204 individuals (mean [SD] age, 58.5 [14.2] years; 1240 [56.2%] female) who did not take GLP-1 RAs.

The GLP-1 RAs group had significantly lower odds of: all-cause mortality (ORs, 0.38; 95% Confidence Interval [CI], 0.28-0.53); hospitalization (ORs, 0.66; 95% CI, 0.52-0.85); intestinal complications (ORs, 0.47; 95% CI, 0.34-0.66); corticosteroid use (ORs, 0.75; 95% CI, 0.66-0.85); and hepatobiliary manifestations such as cholangitis, bile duct carcinoma and cholelithiasis (ORs, 0.38; 95% CI, 0.23-0.63) in comparison to those patients who were not taking GLP -1 Ras. The incidence of CRC and other extraintestinal manifestations did not demonstrate any significant difference between the two cohorts.

The researchers concluded that patients with UC and obesity taking GLP-1 RAs have lower odds of all-cause mortality, hospitalization, intestinal complications, corticosteroid use, and hepatobiliary manifestations. They recommended that additional prospective studies be conducted to determine the mechanism for these findings.

Reference:

Nieto LM, Narvaez S, Kim DH, et al. P0840 - GLP-1 agonist use is associated with lower complications and mortality in patients with ulcerative colitis and obesity: a national database analysis. Presented at: American College of Gastroenterology. October 27, 2024. Philadelphia, Pennsylvania.