GLP-1 Receptor Agonists Linked to Higher Remission in Ulcerative Colitis: Study
Researchers have found in a retrospective cohort study of patients with ulcerative colitis that treatment with liraglutide or semaglutide was associated with higher remission rates at 12 weeks compared with no GLP-1 receptor agonist use. Weight loss was not independently associated with remission, suggesting that the potential benefit may extend beyond weight reduction. The study was published in Inflammatory Bowel Diseases journal by Budoor A. and colleagues.
In order to assess the clinical impact of GLP-1 RAs for treatment of inflammation, the scientists conducted an electronic medical record review at a tertiary academic health network from 2022 through 2024. The study included adults suffering from ulcerative colitis who started taking either liraglutide or semaglutide for metabolic purposes and continued the therapy for at least 12 weeks. The scientists included the 1:1 matched control group of 150 patients with UC who had no history of exposure to GLP-1 RAs and whose baseline characteristics matched those of the patients receiving the therapy.
The main outcome measure was clinical remission after 12 weeks defined by a partial Mayo score <2 with no rectal bleeding. Clinical disease activity was assessed after 4, 8, and 12 weeks with use of multivariable logistic regression analysis for OR adjustment for clinical remission in presence of immunomodulators and baseline severity of disease.
Key findings:
- Patients receiving GLP-1 RAs achieved significantly higher symptomatic remission rates compared to matched controls at 4 weeks (34.7% vs 15.3%, P = .001), 8 weeks (54.7% vs 18.0%, P < .001), and 12 weeks (66.7% vs 25.3%, P < .001).
- Mean partial Mayo scores in the GLP-1 RA cohort dropped from 5.8 at baseline down to 2.1 at 12 weeks, compared to a modest decrease from 5.8 to 4.6 in the control group (P < .01).
- After adjusting for potential confounders, GLP-1 RA therapy remained independently associated with achieving 12-week remission (adjusted OR 5.90, 95% CI 3.52–9.86; P < .001).
- Semaglutide demonstrated superior efficacy over liraglutide, yielding higher symptomatic remission rates at 12 weeks (72.5% vs 60.0%; OR 1.77, P = .04).
- In a subset of patients undergoing endoscopic evaluation, the GLP-1 RA group demonstrated higher rates of endoscopic remission (58% vs 38%) and overall mucosal improvement (69% vs 47%) relative to controls.
Thus, GLP-1 receptor agonists are capable of delivering impressive reductions in disease activity in ulcerative colitis patients, producing significantly higher remission rates in comparison with conventional treatment. It is evident that GLP-1 RAs have nearly six times more probability to provide the patient with remission, where semaglutide proves to be superior to liraglutide; this demonstrates the potential for immunomodulatory and metabolic effects of this drug.
Reference:
Budoor Alqinai, Swapna Gayam, Jennifer Hadam-Veverka, GLP-1 receptor agonist therapy is associated with increased symptomatic remission in ulcerative colitis: a matched cohort study, Inflammatory Bowel Diseases, 2026;, izag167, https://doi.org/10.1093/ibd/izag167
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