BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) improve glycemic control and promote weight loss but may increase gastric residue, raising concerns during esophagogastroduodenoscopy (EGD). African American patients remain underrepresented in research on these agents.
METHODS: We performed a retrospective cohort study at a single tertiary referral center, including adults (≥ 18 years) undergoing elective EGD. Participants were divided into two groups based on documented GLP-1 RA use within 7 days of EGD versus no use. Outcomes included the presence of residual gastric contents, procedure abortion due to gastric residue, procedural bleeding, and post-procedural hospitalization. We applied multiple imputation for missing data and entropy balancing for covariate adjustment, reporting odds ratios (OR) and 95% confidence intervals (CI).
RESULTS: Among 1408 participants, 270 used GLP-1 RAs. Compared to non-users, GLP-1 RA users had a higher mean body mass index (33 vs. 30 kg/m) and hemoglobin A1c (7.43% vs. 6.54%). In the adjusted analysis, GLP-1 RA treatment was not significantly associated with increased gastric content (OR, 1.52; 95% CI, 0.58-3.99; = 0.395) or other procedural complications. Conversely, GLP-1 RA use was linked to lower post-procedural hospitalization rates (OR, 0.19; 95% CI, 0.06-0.58; = 0.004). 2p p
CONCLUSION: In this predominantly African American cohort, recent GLP-1 RA therapy did not significantly elevate intra-procedural risk or necessitate procedure abortion. These findings suggest that routine discontinuation of GLP-1 RAs prior to EGD may not be universally required, especially for patients benefiting from improved metabolic control. Larger prospective studies are warranted to inform guideline updates for diverse patient populations.
