Can GLP-1 Agonists Be Used Safely in IBD? A Meta-Analysis

Background Obesity is increasingly recognized as a common comorbidity in patients with inflammatory bowel disease (IBD). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used for weight reduction and cardiometabolic risk management. However, their safety and effectiveness in individuals with IBD remain uncertain. Methods We conducted a systematic review through June 2025 to identify studies involving adult patients with IBD treated with GLP-1RAs. Primary outcomes included hospitalization, corticosteroid use, treatment escalation, risk of flare, and IBD-related surgery. Secondary outcomes were changes in weight and body mass index (BMI). Results A total of 10 observational studies, comprising 10,362 patients with IBD (3,479 receiving GLP-1 RAs and 6,883 receiving placebo or other anti-obesity medications), were included. The pooled incidences of hospitalization, corticosteroid use, treatment escalation, flare, and surgery among patients receiving GLP-1RAs were 11%, 11%, 8%, 14%, and 3%, respectively. Use of GLP-1RAs in IBD patients was not associated with an increased risk of corticosteroid use (OR: 0.93; 95% CI: 0.17–5.16; I2 = 11.4%), treatment escalation (OR: 0.70; 95% CI: 0.06–7.62; I2 = 0%), or IBD-related surgery (OR: 0.32; 95% CI: 0.00–313.88; I2 = 92.5%) compared to non–GLP-1 users. Patients treated with GLP-1RAs achieved a percentage total body weight loss of 6.67% (95% CI: 2.93%–10.40%; I2 = 0%), a mean absolute weight loss of 7.33 kg (95% CI: 6.03–8.63; I2 = 0%) and a BMI reduction of 2.48 kg/m2 (95% CI: 0.79–4.17; I2 = 0%) compared to baseline. Conclusion GLP-1 receptor agonists appear to be safe and effective in patients with IBD.