Among 599 patients who underwent bariatric surgery, GLP-1 receptor agonists were not associated with higher odds of adverse events.
The median age of the patients was 47.8 years, with 83% identifying as female.
The median time from surgery to the initiation of antiobesity medications was 30 months.
Using GLP-1 receptor agonists did not show a significantly higher risk of adverse events, with adjusted odds ratios of 1.1.
Initiating antiobesity medications 12 months or more after surgery was associated with a significantly lower risk of adverse events.
Simplified
AIM: To compare the incidence of adverse events (AEs) related to antiobesity medications (AOMs; [GLP-1RAs] vs. non-GLP-1RAs) after bariatric surgery.
METHODS: This single-centre retrospective cohort included patients (aged 16-65 years) who had undergone laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy (cohort entry date) and initiated AOMs. Participants were categorized as users of US Food and Drug Administration (FDA)-approved, off-label, or GLP-1RA AOMs if documented as receiving the medication on or after cohort entry date. Non-GLP-1RA AOMs were phentermine, orlistat, topiramate, canagliflozin, dapagliflozin, empagliflozin, naltrexone, bupropion/naltrexone and phentermine/topiramate. GLP-1RA AOMs included: semaglutide, dulaglutide, exenatide and liraglutide. The primary outcome was incidence. Logistic regression was used to determine the association of AOM exposure with AEs.
RESULTS: We identified 599 patients meeting our inclusion criteria, 83% of whom were female. Their median (interquartile range [IQR]) age was 47.8 (40.9-55.4) years. The median duration of surgery to AOM exposure was 30 months. GLP-1RAs use was not associated with higher odds of AEs: adjusted odds ratio (aOR) 1.1 (95% confidence interval [CI] 0.5-2.6) and aOR 1.1 (95% CI 0.6-2.3) for GLP-1RA versus FDA-approved and off-label AOM use, respectively. AOM initiation ≥12 months after surgery was associated with lower risk of AEs compared to <12 months (aOR 0.01 [95% CI 0.0-0.01]; p < 0.001).
CONCLUSION: Our results showed that GLP-1RA AOMs were not associated with an increased risk of AEs compared to non-GLP-1RA AOMs in patients who had previously undergone bariatric surgery. Prospective studies are needed to identify the optimal timeframe for GLP-1RA initiation.
Key numbers
1.1
Odds of Adverse Events
Adjusted odds ratio for GLP-1RA vs. non-GLP-1RA AOMs
0.01
Lower Odds of Any
Odds ratio for AOM initiation ≥12 months after surgery vs. <12 months
21%
Total Body Weight Loss
Weight loss at 12 months after AOM initiation
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