EVIDENCE OF THE INFLUENCE OF GLUCAGON-LIKE PEPTIDE ANALOGS IN INFLAMMATORY BOWEL DISEASE: A SCOPING REVIEW

Inflammatory bowel disease is a chronic, immune-mediated condition characterized by relapsing intestinal inflammation and progressive tissue damage. Despite advances in biological and small-molecule therapies, a considerable proportion of patients experience suboptimal response, treatment intolerance, or persistent disease activity. In parallel, the growing prevalence of obesity and type 2 diabetes among individuals with inflammatory bowel disease has raised interest in therapeutic agents capable of modulating both metabolic dysfunction and intestinal inflammation. Glucagon-like peptide-1 and glucagon-like peptide-2 receptor agonists have demonstrated anti-inflammatory and intestinotrophic properties in experimental and clinical settings, suggesting a potential role in this population.

To systematically map and synthesize current scientific evidence regarding the effects of glucagon-like peptide-1 and glucagon-like peptide-2 receptor agonists in patients with inflammatory bowel disease.

A scoping review was conducted following established methodological frameworks for evidence synthesis. A comprehensive search of electronic databases was performed to identify pre-clinical, observational, and interventional studies evaluating the effects of glucagon-like peptide-1 and glucagon-like peptide-2 receptor agonists in inflammatory bowel disease. Studies were screened according to predefined eligibility criteria. Data extraction focused on mechanisms of action, inflammatory markers, clinical outcomes, safety profile, and therapeutic implications.

Pre-clinical studies consistently demonstrated that glucagon-like peptide-1 receptor agonists reduce intestinal inflammation through modulation of immune signaling pathways, suppression of pro-inflammatory cytokines, and enhancement of epithelial barrier integrity. Observational human studies suggest potential clinical benefits, including reduction in disease activity and decreased need for corticosteroid escalation in selected patients. Glucagon-like peptide-2 analogs showed pronounced effects on mucosal regeneration, epithelial proliferation, and improved nutrient absorption, particularly in patients with Crohn's disease and intestinal failure. Overall, the available evidence indicates promising metabolic and intestinal benefits; however, most studies were limited by small sample sizes and heterogeneous designs.

Glucagon-like peptide-based therapies represent a promising adjunctive strategy in inflammatory bowel disease due to their anti-inflammatory and regenerative properties. Nevertheless, high-quality randomized controlled trials focusing on diseasespecific clinical, endoscopic, and safety outcomes are necessary to establish their efficacy and therapeutic positioning in routine care.