IBD Journal Scan
Key articles from high impact journals in last month
Editorial Recommendations
JUL-2025
Metformin Shows Promise as Adjunct Therapy in Ulcerative Colitis
This double-blind, randomized controlled study assessed the effectiveness of metformin as an adjunct to mesalamine in 60 patients with mild to moderate ulcerative colitis (UC). Over six months, one group received mesalamine alone, while the other received mesalamine plus metformin. Disease activity was measured using the Disease Activity Index (DAI) and various inflammatory markers including fecal calprotectin, serum CRP, IL-10, and nitric oxide. The metformin group showed significant improvements, with reductions in DAI (p=0.0001), CRP (p=0.019), NO (p=0.04), and calprotectin (p=0.027), along with an increase in anti-inflammatory IL-10 (p=0.04). Strong correlations were observed between DAI and CRP/calprotectin (positive), and DAI and IL-10 (negative). The findings suggest that metformin enhances anti-inflammatory effects and may support sustained remission in UC when used alongside mesalamine.
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Metformin Linked to Improved Outcomes in IBD Patients with Type 2 Diabetes
A retrospective cohort study using the TriNetX database evaluated the impact of metformin on inflammatory bowel disease (IBD) outcomes in patients with type 2 diabetes mellitus (T2DM). Patients with ulcerative colitis (UC) and Crohn’s disease (CD) who started metformin were compared to those on other oral hypoglycemics or insulin, using one-to-one propensity score matching. Among 1323 UC and 1278 CD patients, metformin users had significantly reduced odds of requiring intravenous steroids at 1, 2, and 3 years. For CD patients, metformin also lowered the risk of IBD-related surgery at both 1 year (aOR 0.5) and 3 years (aOR 0.62), though no surgical benefit was observed for UC patients. These results suggest that metformin may positively influence IBD progression in T2DM patients, possibly by modulating inflammation, gut barrier integrity, and microbiota.
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GLP-1 Analogs May Improve IBD Outcomes in Obese Diabetic Patients
This Israeli nationwide cohort study investigated the impact of GLP-1 analogs in 3737 patients with inflammatory bowel disease (IBD) and type 2 diabetes (DM2), including both ulcerative colitis (UC) and Crohn’s disease (CD). Among them, 633 patients received GLP-1 analogs for at least six months. Researchers evaluated the risk of poor outcomes—steroid dependence, advanced IBD therapy, hospitalization, surgery, or death. GLP-1 analog use significantly reduced the risk of adverse outcomes across the full cohort (aHR 0.74), with similar benefits in UC (aHR 0.71) and CD (aHR 0.78). While trends suggested improvement across individual outcomes, only hospitalization showed statistical significance. Notably, the benefits were seen in obese patients (aHR 0.61) but not in non-obese individuals. These findings suggest GLP-1 analogs may offer protective effects in obese IBD patients with DM2, highlighting the need for further research into their mechanisms and potential use in non-diabetic populations.
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Statins Linked to Reduced Surgery and Flares in Ulcerative Colitis, Modest Benefit in Crohn’s
A Swedish nationwide cohort study (2006–2020) examined the effects of statin use on inflammatory bowel disease (IBD) progression in 19,788 patients with ulcerative colitis (UC) and 12,582 with Crohn’s disease (CD). Among these, 1,733 UC and 962 CD patients initiated statins after diagnosis. After propensity score matching, statin users were compared to non-users. Statin use significantly reduced the risk of IBD-related surgery in both UC (aHR 0.55) and CD (aHR 0.54), with numbers needed to treat (NNT) of 345 (UC) and 161 (CD) to prevent one surgery annually. In UC patients, statins also lowered risks of hospitalization (aHR 0.68) and disease flares (aHR 0.86), with NNTs of 145 and 15, respectively. No significant reduction in hospitalization or flare rates was observed in CD. The findings suggest statins may beneficially influence disease course, particularly in UC, warranting further investigation into their role in IBD management.
Global Study Maps Century-Long Evolution of IBD Across Four Epidemiologic Stages
Historically considered a disease of early industrialized regions like North America and Europe, inflammatory bowel disease (IBD) has shown shifting global trends over the past century. Using data from 522 population-based studies across 82 regions from 1920 to 2024, researchers identified the transition of IBD through four epidemiologic stages: emergence (low incidence/prevalence), acceleration (rapidly rising incidence), compounding prevalence (slowing incidence, rising prevalence), and a theoretical fourth stage—prevalence equilibrium—where prevalence may plateau due to demographic aging. While many early industrialized nations now show signs of entering stage 3, newly industrialized regions in Africa, Asia, and Latin America are in stage 2, with rising incidence rates. Stage 4 remains a projection, not yet confirmed by data. This comprehensive spatiotemporal analysis provides the first empirical modeling of IBD’s global evolution, offering critical insight for healthcare systems to anticipate and manage the growing and shifting burden of IBD worldwide.