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Real-World Outcomes of Glucagon-Like Peptide-1 Receptor Agonist Therapy in Obese Patients With Ulcerative Colitis and IPAA With a History of Pouchitis
Journal article   Peer reviewed

Real-World Outcomes of Glucagon-Like Peptide-1 Receptor Agonist Therapy in Obese Patients With Ulcerative Colitis and IPAA With a History of Pouchitis

Aakash Desai, Hany Habib, Himsikhar Khataniar, Francis A Farraye, Priya Sehgal, Edward L Barnes, Gursimran S Kochhar and Jana G Hashash
Inflammatory bowel diseases
09 Dec 2025
DOI: https://doi.org/10.1093/ibd/izaf301
PMID: 41365321
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

There are limited data on the impact of glucagon-like peptide-1 receptor agonist (GLP-1RA) on the risk of recurrent pouchitis after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC). A retrospective cohort study was conducted in the TriNetX Research Network in adult patients with obesity and IPAA for UC with a history of pouchitis in whom a GLP-1RA was initiated compared to those patients in whom a GLP-1RA was not initiated. The primary outcome was the risk of recurrent pouchitis within 12 months. The secondary outcomes were mean number of antibiotic prescriptions, anti-diarrheal medication use, Crohns-like disease of pouch (CLDP), and pouch excision. One-to-one propensity score matching was performed. We identified 43 UC-IPAA patients with obesity and history of pouchitis (mean age 51.7 ± 14.7 years, mean body mass index [BMI] 34.4 ± 6 kg/m2, 60.4% female). After propensity score matching, the GLP-1RA cohort had a significantly decreased risk of recurrent pouchitis (26.3% vs 52.6%; adjusted odds ratio [aOR], 0.32; 95% CI, 0.12-0.84) compared to the control cohort. Mean antibiotic prescriptions were numerically lower in the GLP-1RA cohort (2 vs 4.4, P = .16). Anti-diarrheal medication use was lower in the GLP-1RA cohort (18.4% vs 47.3%; aOR, 0.23; 95% CI, 0.07-0.67). There was no difference in the risk of CLDP. Zero patients required pouch excision in both cohorts. Our study in a small cohort of patients with UC-IPAA and obesity with a history of pouchitis showed that GLP-1RA use was associated with decreased risk of recurrent pouchitis and anti-diarrheal medication use.

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Collaboration types
Domestic collaboration
Web of Science research areas
Gastroenterology & Hepatology
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