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Glucagon like peptide 1 receptor agonists in patients with inflammatory bowel disease: safety, clinical effectiveness and anti-inflammatory mechanisms
Journal article   Open access   Peer reviewed

Glucagon like peptide 1 receptor agonists in patients with inflammatory bowel disease: safety, clinical effectiveness and anti-inflammatory mechanisms

Shannon Fernando, Joy Zhao, Kevan Josloff, Nida Zubair, Aakash Desai, Raina Shivashankar, Patricia L. Kozuch, Cuckoo Choudhary, Gary Lichtenstein and Priya Sehgal
Frontiers in gastroenterology (Lausanne, Switzerland), v 5
01 Aug 2026
DOI: https://doi.org/10.3389/fgstr.2026.1864456
url
https://doi.org/10.3389/fgstr.2026.1864456View
Published, Version of Record (VoR) Open

Abstract

glucagon-like peptide-1 receptor agonists weight loss Inflammatory Bowel Disease Obesity Safety
IntroductionThe prevalence of obesity among patients with inflammatory bowel disease (IBD) continues to rise and is associated with adverse IBD outcomes and diminished treatment response. This study reviews the clinical safety and efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RA) in patients with IBD and comorbid obesity and explores their theorized anti-inflammatory mechanisms.MethodsPublished articles through July 2026 were identified via a PubMed search for a narrative review using terms related to GLP-1RA, IBD, safety, effectiveness, and outcomes. Data extraction focused on GLP-1RA intervention details, IBD-related outcomes and inflammatory markers, and proposed anti-inflammatory mechanisms.ResultsGLP-1RA therapy promotes weight loss in patients with IBD comparable to the general population (about 16 pounds over 18 months). The most frequently reported adverse effects are gastrointestinal, often limiting treatment continuity. Most studies report no significant differences in hospitalization, surgery, steroid use or IBD medication adjustments, and some reported improvement in these outcomes. Data on endoscopic disease activity is limited. Inconsistent effects of GLP-1RA on inflammatory serum biomarkers were noted, with reductions in CRP but no consistent changes in fecal calprotectin.DiscussionAddressing obesity in patients with IBD is an emerging clinical priority. GLP-1RA therapy demonstrates efficacy in promoting weight loss, improving glycemic control, and reducing systemic inflammation, which may benefit IBD disease activity. Longitudinal studies are required to clarify the long-term impact of GLP-1RA on clinical and endoscopic outcomes in IBD.

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