Glucagon-Like Peptide (GLP-1) Receptor Agonists in Inflammatory Bowel Disease: Mechanisms, Clinical Implications, and Therapeutic Potential.

Abstract

Glucagon-like peptide-1 receptor agonists are increasingly recognised for their potential dual benefit in inflammatory bowel disease, offering metabolic advantages alongside emerging anti-inflammatory, immunomodulatory, and gut barrier-enhancing effects. Pre-clinical data demonstrate attenuation of inflammation, preservation of epithelial integrity, and modulation of the microbiome in colitis models. Early retrospective studies in patients with inflammatory bowel disease suggest improved clinical outcomes, such as reduced hospitalisation and surgery rates, particularly in those with obesity. Glucagon-like peptide-1 receptor agonists are already widely used for obesity and diabetes, including increasing self-administration by patients outside medical supervision. Their impact on drug absorption, safety in gastrointestinal disease, and interactions with existing inflammatory bowel disease therapies require further exploration. This review synthesises the mechanistic rationale, pre-clinical evidence, and clinical data to date, highlighting the potential utility and safety considerations of glucagon-like peptide-1 receptor agonists in inflammatory bowel disease and emphasises the need for robust prospective trials to ascertain their safety and efficacy in this patient population.