Comparative outcomes for tirzepatide versus glucagon-like peptide-1 receptor agonists in patients with inflammatory bowel disease: a national propensity matched study.

IF 4.7 Q2 GASTROENTEROLOGY & HEPATOLOGY

Intestinal Research Pub Date : 2026-09-10 DOI:10.5217/ir.2026.00152

Krishan S Patel, Butros Fakhoury, Kavin Parmar, Vinay Jahagirdar, Arun J Sanyal, Juan Pablo Arab, Raseen Tariq

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引用次数: 0

Abstract

Background/aims: Evidence suggests glucagon-like peptide-1 receptor agonists (GLP-1RAs) may improve disease-specific outcomes for inflammatory bowel disease (IBD). Tirzepatide, a dual GLP-1 and glucose-dependent insulinotropic polypeptide receptor agonist, may offer additional benefits. We compared clinical and safety outcomes among patients with IBD treated with tirzepatide versus GLP-1RAs.

Methods: Patients aged ≥ 18 years with IBD were identified within a retrospective multiinstitutional U.S. database who were prescribed tirzepatide or GLP-1RA between May 2022 and January 2025. Propensity score matching (1:1) was performed for demographics, comorbidities, and IBD medications. Outcomes were assessed over 18 months and included intravenous (IV) steroid use, intestinal surgery, emergency department visits, hospitalization, and a composite of IV steroids and surgery. Adverse outcomes were assessed.

Results: After matching, 3,042 patients (mean age, 54.6 years; 71.3% female) were analyzed in each cohort. Median follow-up was 540 days (interquartile range, 478-540 days) for tirzepatide versus 540 days (interquartile range, 540-540 days) for GLP-1RA. Patients taking tirzepatide had a significantly reduced risk of IV steroid use (adjusted hazard ratio [aHR], 0.81; 95% confidence interval [CI], 0.68-0.94) and composite IBD outcomes (aHR, 0.86; 95% CI, 0.73-0.97) with similar risk of hospitalization, emergency department visit and receipt of intestinal surgery. In patients with ulcerative colitis specifically, tirzepatide was similarly associated with a reduced risk of IV steroid use (aHR, 0.82; 95% CI, 0.69-0.97). Adverse outcome risks were similar.

Conclusions: Patients with IBD prescribed tirzepatide may have lower risk of IV steroid use compared to those taking GLP-1RAs. Prospective studies are warranted to validate these results and explore underlying mechanisms.

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替西肽与胰高血糖素样肽-1受体激动剂治疗炎症性肠病患者的比较结果：一项全国性倾向匹配研究

背景/目的：有证据表明胰高血糖素样肽-1受体激动剂（GLP-1RAs）可能改善炎症性肠病（IBD）的疾病特异性结局。tizepatide是一种双重GLP-1和葡萄糖依赖性胰岛素多肽受体激动剂，可能提供额外的益处。我们比较了替西肽与GLP-1RAs治疗的IBD患者的临床和安全性结果。方法：在美国多机构回顾性数据库中确定年龄≥18岁的IBD患者，这些患者在2022年5月至2025年1月期间服用了替西帕肽或GLP-1RA。对人口统计学、合并症和IBD药物进行倾向评分匹配（1:1）。结果评估超过18个月，包括静脉注射（IV）类固醇使用、肠道手术、急诊就诊、住院以及静脉注射类固醇和手术的组合。评估不良结果。结果：匹配后，每个队列共分析3042例患者（平均年龄54.6岁，女性71.3%）。替西肽的中位随访时间为540天（四分位数范围，478-540天），GLP-1RA的中位随访时间为540天（四分位数范围，540-540天）。服用替西帕肽的患者静脉使用类固醇的风险（校正风险比[aHR]， 0.81； 95%可信区间[CI]， 0.68-0.94）和IBD综合结局（aHR, 0.86; 95% CI, 0.73-0.97）显著降低，住院、急诊就诊和接受肠道手术的风险相似。在溃疡性结肠炎患者中，替西帕肽与静脉使用类固醇的风险降低相似（aHR, 0.82; 95% CI, 0.69-0.97）。不良结局风险相似。结论：与服用GLP-1RAs的IBD患者相比，服用替西帕肽的IBD患者静脉使用类固醇的风险较低。有必要进行前瞻性研究来验证这些结果并探索潜在的机制。

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来源期刊

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.