New research presented at the American College of Gastroenterology (ACG) 2025 Annual Scientific Meeting reveals that GLP-1 receptor agonists may significantly reduce the risk of iron deficiency anemia in patients with celiac disease. Dr. Jonathan Ghobrial, an internal medicine resident at Allegheny Health Network Medicine Institute, led the study that highlights the potential for these medications to improve survival rates and reduce nutritional deficiencies in a population vulnerable to malabsorption.
GLP-1 receptor agonists, commonly prescribed for managing type 2 diabetes and obesity, are gaining traction across various medical specialties. Their use has expanded to include various conditions such as chronic kidney disease and metabolic dysfunction-associated steatohepatitis. As this class of medications becomes more widely utilized, emerging evidence suggests a beneficial impact on gastrointestinal function and nutrient absorption.
Dr. Ghobrial and his colleagues emphasized that the influence of GLP-1 receptor agonists on nutritional deficiencies in celiac patients has not been thoroughly studied until now. “This study is the first to evaluate the association between GLP-1 agonist use and key clinical outcomes, including anemia, transfusion, hospitalization, and mortality, in a large-scale analysis of patients with celiac disease,” they stated.
To conduct the study, researchers sourced data from TriNetX, identifying patients with celiac disease using ICD-10 codes. They stratified these patients based on their documented exposure to GLP-1 agonists such as semaglutide, dulaglutide, liraglutide, or exenatide. The analysis involved a 1:1 propensity score matching based on demographics, comorbidities, and relevant laboratory values.
Clinical outcomes of interest included mortality, iron deficiency anemia, transfusion, vitamin B12/folate deficiency, gastrointestinal bleeding, and hemoglobin trends. A total of 18,582 matched patients were analyzed, with 9,291 in each group. The results indicated that patients using GLP-1 receptor agonists had significantly lower mortality rates at 1.9% compared to 3.3% among non-users, with a hazard ratio (HR) of 1.82 (95% CI, 1.51–2.20; P < .001). Additionally, transfusion rates were lower in the GLP-1 group at 0.9% versus 1.3% in the non-user group (HR, 1.50; P = .004).
The findings also revealed that non-GLP-1 users faced a higher risk of iron deficiency anemia, with rates of 5.4% compared to 6.5% for users (HR, 1.26; P = .001). Furthermore, the risk of vitamin B12 or folate deficiency was lower in GLP-1 users at 0.8% versus 1.3% (HR, 1.62; P = .001). While gastrointestinal bleeding rates were slightly higher in the GLP-1 group, the absolute risk remained similar.
The research concludes that in a patient population prone to nutritional deficiencies due to malabsorption, these findings highlight a potential strategy for mitigating such deficiencies. “Although the mechanisms by which GLP-1 agonists reduce the risk of iron deficiency anemia in celiac patients remain unclear, further studies are warranted to explore these findings,” the investigators noted.
This study not only underscores the importance of GLP-1 receptor agonists in managing celiac disease but also opens avenues for future research into their broader implications for nutritional health in affected patients.
