Year 2024 / Volume 116 / Number 9
Original
Effectiveness and safety of a GLP-1 agonist in obese patients with inflammatory bowel disease

478-483

DOI: 10.17235/reed.2024.10305/2024

Clara Ramos Belinchón, Helena Martínez-Lozano, Clara Serrano Moreno, Diego Hernández Castillo, Pablo Lois Chicharro, Pablo Ferreira Ocampo, Ignacio Marín-Jiménez, Irene Bretón Lesmes, Luis Menchén,

Abstract
Background: obesity affects many patients with inflammatory bowel disease (IBD). Glucagon-like peptide (GLP)-1 agonists are a promising therapy for obese patients. However, there is a lack of evidence of the use of these drugs in IBD patients. This study investigated the effectiveness and safety of GLP-1 agonists in a cohort of obese patients with IBD. Methods: a retrospective series of cases of consecutive IBD patients who received GLP-1 agonists indicated to treat obesity between 2019 and 2021 was analyzed. The GLP-1 agonists included were semaglutide 1.0 mg or liraglutide 3.0 mg. The coprimary endpoints were the percentage of change in body weight from baseline to six months and a weight reduction of 5 % or more at six months. In addition, the safety profile of GLP-1 agonist therapy and its impact on the IBD course were reviewed. Results: sixteen obese patients with IBD (nine with Crohn’s disease [CD] and seven with ulcerative colitis [UC]) were included in the study. The median body mass index at baseline was 35 (32-37). The percentage of change in body weight was -6.2 % (-3.4-[-8.5]) at six months, and a 5 % or more weight reduction was achieved in 58.3 % (7/12) of patients at six months. The most common side effect was nausea (13.3 %), and one patient withdrew due to diarrhea. IBD activity score did not change significantly during follow-up. Conclusion: our results showed that GLP-1 agonists were effective and had a good safety profile in IBD patients. Most adverse effects were mild, and the IBD activity had no significant changes.
Lay Summary
Obesity prevalence is increasing among patients with inflammatory bowel disease; Glucagon-like peptide (GLP)-1 agonists are commonly used for diabetes mellitus, and their indication for obesity has increased in the last few years. In this observational study, GLP-1 agonists were effective, in terms of body weight reduction, and safe in obese IBD patients.
Share Button
New comment
Comments
No comments for this article
References
1. Haslam DW, James WPT. Obesity. Lancet. 2005 Oct 1;366(9492):1197–209.
2. Flores A, Burstein E, Cipher DJ, Feagins LA. Obesity in Inflammatory Bowel Disease: A Marker of Less Severe Disease. Dig Dis Sci. 2015 Aug 23;60(8):2436–45.
3. Seminerio JL, Koutroubakis IE, Ramos-Rivers C, Hashash JG, Dudekula A, Regueiro M, et al. Impact of Obesity on the Management and Clinical Course of Patients with Inflammatory Bowel Disease. Inflamm Bowel Dis. 2015 Aug 6 21(12):2857–63.
4. Nic Suibhne T, Raftery TC, McMahon O, Walsh C, O’Morain C, O’Sullivan M. High prevalence of overweight and obesity in adults with Crohn’s disease: associations with disease and lifestyle factors. J Crohns Colitis. 2013;7(7).
5. Pringle PL, Stewart KO, Peloquin JM, Sturgeon HC, Nguyen D, Sauk J, et al. Body Mass Index, Genetic Susceptibility, and Risk of Complications Among Individuals with Crohn’s Disease. Inflamm Bowel Dis. 2015 Jul 20;21(10):2304–10.
6. Johnson A, Loftus E. Obesity in inflammatory bowel disease: A review of its role in the pathogenesis, natural history, and treatment of IBD. Saudi J Gastroenterol. 2021 Jul 1;27(4):183–90.
7. Sharma S, Eckert D, Hyams JS, Mensing S, Thakkar RB, Robinson AM, et al. Pharmacokinetics and exposure-efficacy relationship of adalimumab in pediatric patients with moderate to severe Crohn’s disease: results from a randomized, multicenter, phase-3 study. Inflamm Bowel Dis. 2015 Mar 6;21(4):783–92.
8. Dotan I, Ron Y, Yanai H, Becker S, Fishman S, Yahav L, et al. Patient factors that increase infliximab clearance and shorten half-life in inflammatory bowel disease: a population pharmacokinetic study. Inflamm Bowel Dis. 2014 Dec 1;20(12):2247–59.
9. Upala S, Sanguankeo A. Effect of lifestyle weight loss intervention on disease severity in patients with psoriasis: a systematic review and meta-analysis. Int J Obes (Lond). 2015 Aug 6;39(8):1197–202.
10. Al-Mutairi N, Nour T. The effect of weight reduction on treatment outcomes in obese patients with psoriasis on biologic therapy: a randomized controlled prospective trial. Expert Opin Biol Ther. 2014;14(6):749–56.
11. Grill HJ. A Role for GLP-1 in Treating Hyperphagia and Obesity. Endocrinology. 2020;161(8):1–14.
12. Villumsen M, Schelde AB, Jimenez-Solem E, Jess T, Allin KH. GLP-1 based therapies and disease course of inflammatory bowel disease. EClinicalMedicine. 2021 Jul 1;37.
13. Pham JT, Ghusn W, Acosta A, Loftus E V., Johnson AM. Effectiveness and Safety of Antiobesity Medications in Patients With Obesity and Inflammatory Bowel Disease. Am J Gastroenterol. 2023 Oct 9.
14. Silverberg MS, Satsangi J, Ahmad T, Arnott IDR, Bernstein CN, Brant SR, et al. Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol. 2005;19 Suppl A.
15. Harvey RF, Bradshaw JM. A simple index of Crohn’s-disease activity. Lancet. 1980 Mar 8;1(8167):514.
16. Pratley RE, Nauck M, Bailey T, Montanya E, Cuddihy R, Filetti S, et al. Liraglutide versus sitagliptin for patients with type 2 diabetes who did not have adequate glycaemic control with metformin: a 26-week, randomised, parallel-group, open-label trial. Lancet. 2010;375(9724):1447–56.
17. Mehta A, Marso SP, Neeland IJ. Liraglutide for weight management: a critical review of the evidence. Obes Sci Pract. 2017 Mar 1;3(1):3–14.
18. Le Roux C, Aroda V, Hemmingsson J, Cancino AP, Christensen R, Pi-Sunyer X. Comparison of Efficacy and Safety of Liraglutide 3.0 mg in Individuals with BMI above and below 35 kg/m2: A Post-hoc Analysis. Obes Facts. 2017 Feb 1;10(6):531–44.
19. Wadden TA, Hollander P, Klein S, Niswender K, Woo V, Hale PM, et al. Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss: the SCALE Maintenance randomized study. Int J Obes (Lond). 2013 Nov;37(11):1443–51.
20. O’Neil PM, Birkenfeld AL, McGowan B, Mosenzon O, Pedersen SD, Wharton S, et al. Efficacy and safety of semaglutide compared with liraglutide and placebo for weight loss in patients with obesity: a randomised, double-blind, placebo and active controlled, dose-ranging, phase 2 trial. Lancet. 2018 Aug 25;392(10148):637–49.
21. Pratley RE, Aroda VR, Lingvay I, Lüdemann J, Andreassen C, Navarria A, et al. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial. Lancet Diabetes Endocrinol. 2018 Apr 1;6(4):275–86.
22. Ahmann AJ, Capehorn M, Charpentier G, Dotta F, Henkel E, Lingvay I, et al. Efficacy and Safety of Once-Weekly Semaglutide Versus Exenatide ER in Subjects With Type 2 Diabetes (SUSTAIN 3): A 56-Week, Open-Label, Randomized Clinical Trial. Diabetes Care. 2018 Feb 1;41(2):258–66.
23. Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med. 2015 Jul 2;373(1):11–22.
24. Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 18;384(11):989–1002.
25. Lean MEJ, Carraro R, Finer N, Hartvig H, Lindegaard ML, Rössner S, et al. Tolerability of nausea and vomiting and associations with weight loss in a randomized trial of liraglutide in obese, non-diabetic adults. Int J Obes (Lond). 2014;38(5):689–97.
26. Farr OM, Sofopoulos M, Tsoukas MA, Dincer F, Thakkar B, Sahin-Efe A, et al. GLP-1 receptors exist in the parietal cortex, hypothalamus and medulla of human brains and the GLP-1 analogue liraglutide alters brain activity related to highly desirable food cues in individuals with diabetes: a crossover, randomised, placebo-controlled trial. Diabetologia. 2016 May 1;59(5):954–65.
27. Sorli C, Harashima S ichi, Tsoukas GM, Unger J, Karsbøl JD, Hansen T, et al. Efficacy and safety of once-weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1): a double-blind, randomised, placebo-controlled, parallel-group, multinational, multicentre phase 3a trial. Lancet Diabetes Endocrinol. 2017 Apr 1;5(4):251–60.
28. Rodbard HW, Lingvay I, Reed J, De La Rosa R, Rose L, Sugimoto D, et al. Semaglutide Added to Basal Insulin in Type 2 Diabetes (SUSTAIN 5): A Randomized, Controlled Trial. J Clin Endocrinol Metab. 2018 Jun 1;103(6):2291–301.
Related articles

Letter

Hepatosplenic T-cell lymphoma and inflammatory bowel disease

DOI: 10.17235/reed.2023.9472/2023

Digestive Diseases Image

A giant cause of recurrent fever

DOI: 10.17235/reed.2022.9340/2022

Digestive Diseases Image

A case of esophageal histoplasmosis mimicking carcinoma on endoscopy

DOI: 10.17235/reed.2023.9167/2022

Review

Clinical settings with tofacitinib in ulcerative colitis

DOI: 10.17235/reed.2022.8660/2022

Letter

Anal neoplasia and perianal Crohn’s disease: myth or reality?

DOI: 10.17235/reed.2021.8317/2021

Letter

Apoptotic colopathy as a manifestation of Good’s syndrome

DOI: 10.17235/reed.2021.8297/2021

Original

Radon exposure and inflammatory bowel disease in a radon prone area

DOI: 10.17235/reed.2021.8239/2021

Review

Inflammatory bowel disease and solid organ transplantation

DOI: 10.17235/reed.2020.7361/2020

Editorial

Is celiac disease really associated with inflammatory bowel disease?

DOI: 10.17235/reed.2019.6779/2019

Original

Megacolon in inflammatory bowel disease: response to infliximab

DOI: 10.17235/reed.2020.6394/2019

Editorial

Diet in the etiology of inflammatory bowel disease

DOI: 10.17235/reed.2018.6119/2018

Case Report

Serrated Lesions in patients with Inflammatory Bowel Disease.

DOI: 10.17235/reed.2019.5910/2018

Editorial

Online social networks and inflammatory bowel disease

DOI: 10.17235/reed.2018.5496/2018

Letter to the Editor

Idiopathic portal hypertension with regard to thiopurine treatment

DOI: 10.17235/reed.2018.5256/2017

Letter to the Editor

GETTEMO position statement on bariatric endoscopic techniques as a voluntary medicine

DOI: 10.17235/reed.2017.5144/2017

Original

Usefulness of an intra-gastric balloon before bariatric surgery

DOI: 10.17235/reed.2017.4624/2016

Editorial

Specialist care in the management of inflammatory bowel disease

DOI: 10.17235/reed.2016.4628/2016

Original

Multicenter study on the safety of bariatric endoscopy

DOI: 10.17235/reed.2017.4499/2016

Citation tools
Ramos Belinchón C, Martínez-Lozano H, Serrano Moreno C, Hernández Castillo D, Lois Chicharro P, Ferreira Ocampo P, et all. Effectiveness and safety of a GLP-1 agonist in obese patients with inflammatory bowel disease. 10305/2024


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 508 visits.
This article has been downloaded 53 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 27/01/2024

Accepted: 07/05/2024

Online First: 20/05/2024

Published: 09/09/2024

Article revision time: 81 days

Article Online First time: 114 days

Article editing time: 226 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology