在炎症性肠病中可以安全使用GLP-1激动剂吗? 一个元分析
Noppachai Siranart1, Pannathorn Nakaphan2, Patavee Pajareya3
1Department of Gastroenterology, Brigham and Women's Hospital, Boston, MA, United States.
Journal of Crohn's & colitis
|November 10, 2025
概括
类似葡萄糖类-1受体激动剂 (GLP-1RAs) 显示出对治疗炎症性肠病 (IBD) 患者肥胖的有前途. 这次审查发现GLP-1RAs是安全有效的,导致显著的体重减轻,而不会增加IBD并发症.
科学领域:
- 胃肠道学和内分泌学
- 药理学和治疗学 药理学和治疗学
背景情况:
- 肥胖是诊断为炎症性肠病 (IBD) 的患者经常出现的并发症.
- 类似葡萄糖-1受体激动剂 (GLP-1RAs) 已成为减肥和心脏代谢风险的治疗方法,但它们在IBD中的作用尚不清楚.
研究的目的:
- 系统地审查GLP-1RAs在IBD成年患者的安全性和有效性.
- 评估GLP-1RAs对IBD相关临床结果和体重管理的影响.
主要方法:
- 对2025年6月之前发表的观察性研究进行了系统审查.
- 包括专注于接受GLP-1RA治疗的成人IBD患者的研究,将结果与非GLP-1RA用户进行比较.
- 主要结局包括住院治疗,使用皮质类固醇,治疗升级,疾病爆发和IBD相关的手术;次要结局是体重和BMI变化.
主要成果:
- 分析了10项涉及10362名IBD患者的研究 (3479名GLP-1RA患者).
- 使用GLP-1RA并没有增加住院,使用皮质类固醇,治疗升级或IBD相关手术的风险.
- 接受GLP-1RA治疗的患者经历了显著的体重减轻 (总体重6.67%,绝对7.33公斤) 和BMI减轻 (2.48公斤/米2).
结论:
- GLP-1受体激活剂 (GLP-1RAs) 在炎症性肠病 (IBD) 患者中显示出良好的安全性.
- 在IBD患者群体中,GLP-1RA对减肥和BMI管理是有效的.
- 这些发现支持GLP-1RAs作为肥胖IBD患者的治疗选择.
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