The impact of glucagon-like peptide 1-receptor agonists on metabolic health and disease activity in patients with inflammatory bowel disease: a scoping review

Abstract

Background: Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, is a chronic, immune-mediated disorder characterised by relapsing intestinal inflammation. The increasing prevalence of metabolic comorbidities, such as obesity and type 2 diabetes mellitus (T2DM), complicates IBD management, necessitating therapies that address both conditions. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are widely used for glycaemic control and weight reduction, however, emerging evidence suggests they may also exert anti-inflammatory effects, potentially influencing IBD activity. Nevertheless, their clinical impact on IBD remains unclear. This scoping review synthesises available evidence on the role of GLP-1 RAs in metabolic health and disease progression in IBD patients.

Methods: A systematic literature search was conducted using PubMed, Scopus, and Google Scholar, encompassing studies published up to 11 March 2025. Boolean search strings included terms related to GLP-1 RAs, IBD, metabolic outcomes (weight loss, glycaemic control), and disease activity (flares, hospitalisation, inflammatory markers). Observational studies and clinical trials evaluating the effects of GLP-1 RAs in adult IBD patients were included. Two reviewers independently screened studies, extracted data, and synthesised findings narratively and in tabular form.

Results: A total of 10 studies met the inclusion criteria, including eight retrospective cohort studies, one case–control study, and one case series. Across all studies, GLP-1 RAs were associated with significant weight loss (5–8 kg over 6–12 months) and no increase in IBD exacerbations. Two large nationwide cohort studies demonstrated reduced hospitalisation and corticosteroid use in GLP-1 RA users compared with non-users. Several studies reported reductions in inflammatory biomarkers, such as C-reactive protein (CRP) and tumour necrosis factor-alpha (TNF-α), suggesting potential immunomodulatory effects. Importantly, no study reported a worsening in IBD activity.

Conclusion: Current evidence suggests that GLP-1 RAs are safe in IBD patients and may confer metabolic and potential anti-inflammatory benefits. However, findings remain inconsistent, and prospective controlled trials are needed to clarify their role in IBD management.