Impact of GLP-1 analogues on immune-mediated inflammatory diseases: A systematic review

Chhagan L Birda; Fadwa Ibrahim; Abhirup Chatterjee; Anuraag Jena; Vishal Sharma; Shaji Sebastian

doi:10.1016/j.autrev.2025.103936

Impact of GLP-1 analogues on immune-mediated inflammatory diseases: A systematic review

Autoimmun Rev. 2026 Jan;25(1):103936. doi: 10.1016/j.autrev.2025.103936. Epub 2025 Oct 10.

Authors

Chhagan L Birda¹, Fadwa Ibrahim², Abhirup Chatterjee³, Anuraag Jena⁴, Vishal Sharma⁵, Shaji Sebastian⁶

Affiliations

¹ Department of Gastroenterology, All India Institute of Medical Sciences, Jodhpur, India.
² Hull University Teaching Hospitals, Hull, UK; Alexandria University Hospitals, Alexandria, Egypt.
³ Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
⁴ Department of Gastroenterology, IMS and SUM Hospital, Bhubaneswar, Odisha, India.
⁵ Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: sharma.vishal@pgimer.edu.in.
⁶ Hull University Teaching Hospitals, Hull, UK. Electronic address: shaji.sebastian4@nhs.net.

PMID: 41077375
DOI: 10.1016/j.autrev.2025.103936

Abstract

Objective: Glucagon-like peptide-1 receptor agonists (GLP1RA) are believed to have anti-inflammatory properties apart from antidiabetic and anti-obesity effects.

Methods: We performed a systematic review to evaluate the efficacy and safety of GLP1RA in immune-mediated inflammatory disorders (IMIDs). A systematic search was done on 3rd April 2025 in PubMed, Scopus, and Embase for studies reporting the use of GLP1RA among patients with IMIDs. Because of significant heterogeneity and overlapping data originating from the same insurance databases, we decided against performing a data synthesis and meta-analysis. We summarised the data regarding clinical and metabolic outcomes in patients with IMIDs with/without the use of GLP1RA.

Results: Thirty-three studies (20 full text, 13 conference abstracts) were included, of which 20 studies focused on inflammatory bowel disease (IBD) and 13 on other IMIDs. Of the three studies reporting on new onset IBD/IMID in GLP1RA users, 2 showed a lower incidence. IBD therapy utilization was reported in 13 studies; steroid use was lower in 5 studies, but the data on the use of biologics were inconclusive. Other outcomes, like hospitalization, IBD complications, surgery, and mortality, seemed to be better in GLP1RA cohorts in a few of the studies. Similarly, psoriasis disease activity-related outcomes were better in the GLP1RA cohort, but the effect on other IMIDs was limited by sparse literature. A total of 12 studies reported metabolic outcomes, including weight loss, glycaemic control, waist circumference, and lipid parameters, all of which showed beneficial effects of GLP1RAs, and these results were comparable to non-IBD/IMID controls. Adverse events (AEs) were reported by 13 studies; gastrointestinal (GI) AEs were higher in the GLP1RA cohort (but the majority were non-severe).

Conclusion: GLP1RA use is associated with better disease activity and metabolic outcomes in patients with IMIDs and concomitant metabolic disorders.

Registration: https://osf.io/jvmz6.

Keywords: Bullous disorders; Diabetes; Disease activity; Glucagon-like peptide 1 analogues; Inflammatory bowel disease; Metabolic syndrome; Obesity; Psoriasis; autoimmune diseases.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Anti-Inflammatory Agents* / therapeutic use
Glucagon-Like Peptide 1* / analogs & derivatives
Glucagon-Like Peptide 1* / therapeutic use
Glucagon-Like Peptide-1 Receptor Agonists* / therapeutic use
Humans
Inflammation* / drug therapy
Inflammation* / immunology
Inflammatory Bowel Diseases* / drug therapy
Inflammatory Bowel Diseases* / immunology

Substances

Anti-Inflammatory Agents
Glucagon-Like Peptide 1
Glucagon-Like Peptide-1 Receptor Agonists