Efficacy of tirzepatide for weight loss and it's comparative effectiveness to weight loss surgery in inflammatory bowel disease.

BACKGROUND AND AIMS: There is limited data about tirzepatide's (TZP) efficacy for weight loss in patients with inflammatory bowel disease (IBD). METHODS: A retrospective cohort study was conducted using the US Collaborative Network in patients with IBD on TZP between January 5, 2022 and December 31, 2023. The objective was to assess mean total body weight (TBW) change in pounds (lbs) in the IBD TZP cohort compared to the non-IBD TZP cohort and IBD cohort with weight loss surgery (WLS) from baseline to between six and 15 months. 1:1 propensity score matching was performed for demographics, comorbid conditions, body mass index (BMI) and body weight. RESULTS: There were 274 patients in the IBD TZP cohort (mean age 53.6 ± 11.9, 66.4% diabetes mellitus, BMI 38.3 ± 7.7 kg/m). There was no difference in the TBW change between the IBD and non-IBD cohort on TZP (-21 lbs [ 95% CI -30 to -12] vs. -21 lbs [-30 to -11], p = 1.0). There was no difference in the TBW based on time interval, IBD type, IBD medications, surgery and TZP dose. There was a lower TBW change compared to the IBD WLS cohort (-21 lbs [-36 to -5] vs. -55 lbs [-68 to -41], p < 0.0001). There was higher TBW change with 15 mg TZP (-29 lbs [-45 to -12]) compared to 5-10 mg TZP (-15 lbs [-36 to 6]), however, lower compared to the IBD WLS cohort. CONCLUSION: TZP use was associated with a similar mean weight loss of > 10% in patients with IBD compared to patients without IBD, however lower compared to WLS.