Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA.
Division of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA.
Aliment Pharmacol Ther. 2024 Sep;60(5):620-632. doi: 10.1111/apt.18138. Epub 2024 Jun 27.
Glucagon-like peptide-1 receptor agonists (GLP-1RA) show anti-inflammatory properties.
To evaluate their clinical impact on inflammatory bowel disease (IBD) outcomes.
Retrospective cohort study utilising the TriNetX database comparing IBD-specific outcomes in patients with ulcerative colitis (UC) or Crohn's disease (CD) and type 2 diabetes mellitus (T2DM) on GLP-1RA compared to oral hypoglycaemic agents. The primary outcome was hospitalisation requiring intravenous steroids and IBD-related surgery within 3 years. We performed 1:1 propensity score matching (PSM) for demographics, co-morbid conditions, BMI, laboratory values, HbA1c, and IBD medications including steroids.
We identified 1130 patients in the UC GLP-1RA cohort (mean age: 58.9 ± 11.6 years, 56.3% female, 70.2% White, 57.2% with obesity) and 1140 patients in the CD GLP-1RA cohort (mean age: 56.7 ± 11.5, 61.9% female, 73.6% White, 56.2% with obesity). After PSM, there was no difference in the risk of intravenous steroid use (aHR: 1.21, 95% CI: 0.92-1.59) but a lower risk of colectomy (aHR: 0.37, 95% CI: 0.14-0.97) between the UC GLP-1RA and control cohort. There was no difference in the risk of intravenous steroid use (aHR: 1.04, 95% CI: 0.80-1.34) but a lower risk of surgery (aHR: 0.55, 95% CI: 0.36-0.84) between the CD GLP-1RA and CD control cohort. There was no difference in the risk of oral steroid use or advanced therapy initiation in the UC and CD GLP-1RA than control cohorts.
We found an association between lower risk of IBD-related surgery and GLP-1RA use for T2DM in patients with UC or CD.
胰高血糖素样肽-1 受体激动剂 (GLP-1RA) 具有抗炎作用。
评估其对炎症性肠病 (IBD) 结局的临床影响。
利用 TriNetX 数据库进行回顾性队列研究，比较溃疡性结肠炎 (UC) 或克罗恩病 (CD) 合并 2 型糖尿病 (T2DM) 患者使用 GLP-1RA 与口服降糖药的 IBD 特异性结局。主要结局是在 3 年内需要静脉用类固醇和 IBD 相关手术的住院治疗。我们对人口统计学、合并症、BMI、实验室值、HbA1c 和包括类固醇在内的 IBD 药物进行了 1:1 倾向评分匹配 (PSM)。
我们在 UC GLP-1RA 队列中确定了 1130 名患者（平均年龄：58.9±11.6 岁，56.3%为女性，70.2%为白人，57.2%为肥胖），在 CD GLP-1RA 队列中确定了 1140 名患者（平均年龄：56.7±11.5 岁，61.9%为女性，73.6%为白人，56.2%为肥胖）。PSM 后，UC GLP-1RA 组与对照组静脉用类固醇使用率的风险无差异（aHR：1.21，95%CI：0.92-1.59），但结直肠切除术的风险较低（aHR：0.37，95%CI：0.14-0.97）。CD GLP-1RA 组与 CD 对照组静脉用类固醇使用率的风险无差异（aHR：1.04，95%CI：0.80-1.34），但手术风险较低（aHR：0.55，95%CI：0.36-0.84）。UC 和 CD GLP-1RA 组与对照组相比，口服类固醇使用率或高级治疗的起始率均无差异。
我们发现，在 UC 或 CD 患者中，T2DM 患者使用 GLP-1RA 与 IBD 相关手术风险降低之间存在关联。
