Background: Obesity is increasingly recognized as a common comorbidity in patients with inflammatory bowel disease (IBD). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used for weight reduction and cardiometabolic risk management. However, their safety and effectiveness in individuals with IBD remain uncertain. Methods: We conducted a systematic review through June 2025 to identify studies involving adult patients with IBD treated with GLP-1RAs. Primary outcomes included hospitalization, corticosteroid use, treatment escalation, risk of flare, and IBD-related surgery. Secondary outcomes were changes in weight and body mass index (BMI). Results: Ten observational studies, comprising 10 362 patients with IBD (3479 receiving GLP-1RAs and 6883 receiving placebo or other anti-obesity medications) were included. The pooled incidences of hospitalization, corticosteroid use, treatment escalation, flare, and surgery among patients receiving GLP-1RAs were 11%, 11%, 8%, 14%, and 3%, respectively. Use of GLP-1RAs in IBD patients was not associated with an increased risk of corticosteroid use (OR: 0.93; 95% CI: 0.17-5.16; I2 = 11.4%), treatment escalation (OR: 0.70; 95% CI: 0.06-7.62; I2 = 0%), or IBD-related surgery (OR: 0.32; 95% CI: 0.00-313.88; I2 = 92.5%) compared to non-GLP-1 users. Patients treated with GLP-1RAs achieved a percentage total body weight loss of 6.67% (95% CI: 2.93%-10.40%; I2 = 0%), a mean absolute weight loss of 7.33 kg (95% CI: 6.03-8.63; I2 = 0%) and a BMI reduction of 2.48 kg/m2 (95% CI: 0.79-4.17; I2 = 0%) compared to baseline. Conclusion: GLP-1RAs appear to be safe and effective in patients with IBD.

Objective: Calcium pyrophosphate deposition disease (CPPD) is a common inflammatory arthritis among older adults. Comorbidities often limit conventional treatment of acute CPPD flare. Anakinra, an interleukin-1 inhibitor, is a promising alternative. We aimed to evaluate the efficacy and safety of anakinra in acute CPPD flares. Methods: We systematically searched studies from MEDLINE, EMBASE, and the Cochrane Database up until August 2024. The primary outcome was a positive treatment response between Day 3 and Day 5 after anakinra initiation. Secondary outcomes included changes in pain ratings assessed by the visual analogue scales (VAS), C-reactive protein (CRP) levels, tender joint counts (TJCs), swollen joint counts (SJCs), and steroid usage. Results: Six studies were included in our meta-analysis: five observational studies and one randomized controlled trial. A total of 84 patients were included in our analysis. Subjective physician assessments of clinical response were reported in all studies with a combined positive treatment response rate of 76% (95% CI: 61–86, I2 = 0%). Our pooled analysis also showed a significant reduction of VAS scores by 48.12 mm (95% CI: 53.21–43.03, I2 = 0%) and CRP levels by 62.09 mg/L (95% CI: 97.74–26.44, I2 = 77%) from baseline. Reductions of TJC and SJC were also demonstrated: 4.86 (95% CI: 5.48–4.23, I2 = 0%) and 3.65 (95% CI: −12.53 to 5.22, I2 = 54%), respectively. Adverse reactions included injection site reaction, rash, bacterial pneumonitis, and neutropenia. Conclusions: Anakinra is a promising alternative treatment for patients with acute CPPD flare as it showed desirable clinical responses and a favourable safety profile.

INTRODUCTION: Non-variceal upper gastrointestinal bleeding (NVGIB) represents an urgent medical condition with high mortality. Standard endoscopic therapies (ST) still carry a high rebleeding rate. Novel modalities such as the over-the-scope clip (OTSC) and hemostatic powder (HP) could be promising alternatives, but their efficacy and cost-effectiveness remain to be explored. METHODS: A network meta-analysis and cost-effectiveness analyses were conducted to compare OTSC vs HP vs ST. Primary endpoints include 30-day rebleeding and 30-day further bleeding. Markov models with a 12-month time horizon were created across 3 different health care settings: the United States, Thailand with Boston Scientific products (TH-BOS), and Thailand with China-manufactured alternatives (TH-CHN). Incremental cost-effectiveness ratio (ICER) was evaluated at a willingness-to-pay of $100,000 per quality-adjusted life year for the US model and THB 150,000 per quality-adjusted life year for the TH-BOS and TH-CHN models. RESULTS: Ten randomized controlled trials with 1,120 patients with NVGIB were included in the network meta-analysis. Lowest 30-day rebleeding was seen in OTSC ( P -score: 0.996), followed by ST (0.296) and HP (0.208). Similarly, OTSC also achieved lowest 30-day further bleeding (0.906), followed by HP (0.570) and ST (0.024). In cost-effective analysis, the US model reported OTSC as a dominant approach compared with HP (ICER: −$314) and ST (−$3,112). In the TH model, OTSC still dominated ST (ICER: −THB 28,423 for TH-BOS and −22,858 for TH-CHN) and was more cost-effective than HP (THB 1,833 for TH-BOS and THB 2,026 for TH-CHN). DISCUSSION: OTSC was superior to HP and ST in efficacy and cost-effectiveness, favoring its use as a first-line endoscopic hemostasis intervention for NVGIB.