Our review paper examined the early evidence presented on the effect of GLP-1 RAs on gastrointestinal disorders and diseases 1. However, as the authors note, the data, specifically on the medication's anti-inflammatory effects in patients with IBD, remain largely observational and highlight a clear and pressing need for additional research within gastroenterology, especially when compared to the more well-researched subject of metabolic dysfunction-associated steatohepatitis 2. We not only agree with the authors' concern with confounding and indication bias when analysing registry data, but also with their suggestion that the next phase of investigation should prioritise prospective, IBD-specific study designs that integrate both metabolic and inflammatory endpoints 2. From our perspective, the most important contribution of future IBD-focused studies will be their ability to clarify how metabolic context shapes treatment response. Studying these agents alongside established IBD treatments may help determine whether metabolic modulation meaningfully alters disease course in selected patients. Until such data are available, decisions to initiate GLP-1 solely for IBD treatment should be cautioned. The expanding use of GLP-1 receptor agonists in gastroenterology, particularly with the introduction of oral formulations such as oral semaglutide, further emphasises the need for targeted investigation that can guide appropriate patient selection and interpretation of outcomes. Sydney Pomenti: writing – original draft, writing – review and editing. Annabel Gerber: writing – original draft, writing – review and editing. David Katzka: writing – original draft, writing – review and editing. Michael Camilleri: writing – original draft, writing – review and editing. Chin Hur: writing – original draft, writing – review and editing, project administration. We thank the authors for their thoughtful commentary on our article and for further contextualising the evolving role of GLP-1 RAs in gastroenterology. We agree that the expanding use of these medications reflects both the rising burden of obesity and metabolic disease and the reassurance of its safety. The authors have nothing to report. S.P., A.G., D.K. C.H. no relevant disclosures. M.C. advisor/consultant to Lilly with compensation to Mayo Clinic. This article is linked to Pomenti et al. papers. To view these articles, visit https://doi.org/10.1111/apt.70450 and https://doi.org/10.1111/apt.70538. Data sharing not applicable to this article as no datasets were generated or analysed during the current study.
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