Abstract Background GLP-1 receptor agonists have demonstrated metabolic and potential anti-inflammatory benefits, but their influence on disease-related outcomes in diabetic patients with inflammatory bowel disease (IBD) receiving adalimumab remains poorly defined. This study evaluated whether GLP-1 exposure is associated with improved inflammatory, gastrointestinal, and hospitalization outcomes in this high-risk population. Methods A retrospective cohort study was conducted using the TriNetX U.S. Collaborative Network. Adults (≥18 years) with IBD and diabetes who initiated adalimumab between 2015–2024 were stratified into GLP-1–exposed (Cohort 1) and GLP-1–naïve (Cohort 2) groups. Pregnancy-positive patients were excluded. Propensity score matching (1:1) produced balanced cohorts of 1,070 patients each. Outcomes assessed over 730 days included bloody stools, infection, abdominal pain, inpatient admission, nausea/vomiting, malnutrition, vitamin D deficiency, DVT/PE, and acute pancreatitis. Acute pancreatitis was included a priori; however, TriNetX returned insufficient case counts to support statistical analysis. Measures of association and Kaplan-Meier survival were reported using odds ratios (OR), risk ratios, and hazard ratios (HR). Results Most outcomes demonstrated numerically lower risks among GLP-1–exposed patients, with statistically significant reductions in malnutrition (5.6% vs 9.6%; OR 0.558, 95% CI 0.401–0.776; p 0.001) and DVT/PE (4.2% vs 6.8%; OR 0.600, 95% CI 0.409–0.878; p = 0.008). Additional nonsignificant trends favored GLP-1 use for infection (23.5% vs 26.0%), inpatient admissions (29.9% vs 33.6%), and bloody stools (13.9% vs 15.7%). Rates of abdominal pain, nausea/vomiting, and vitamin D deficiency were similar between cohorts. Kaplan-Meier analyses demonstrated improved survival free of malnutrition and DVT/PE in the GLP-1 group. Acute pancreatitis could not be evaluated due to insufficient patient events. Conclusion Among diabetic patients with IBD treated with adalimumab, GLP-1 receptor agonist exposure was associated with reduced risks of malnutrition and thromboembolic events, with favorable but nonsignificant trends for several additional outcomes. Although acute pancreatitis was included as an outcome, no analyzable data were returned. These findings support a potential protective role of GLP-1 therapy in metabolically complex IBD populations and highlight opportunities for further investigation. Conflict of interest: Dr. Patel, Om: No conflict of interest Johal, Jashanveer: No conflict of interest Al-Bataineh, Mahmoud: No conflict of interest Hussein, Abdallah: No conflict of interest Schneider, Yecheskel: No conflict of interest Hyman, Jason: No conflict of interest
Patel et al. (Thu,) studied this question.
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