Effect of Glucagon-Like Peptide-1 Receptor Agonists on Bowel Preparation for Colonoscopy: A Systematic Review and Meta-Analysis

🥉 Top 5% JournalFeb 11, 2025The American journal of gastroenterology

How Diabetes Medicines That Activate GLP-1 Receptors Affect Colon Cleansing Before Colonoscopy

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GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗

Abstract

The inadequate bowel preparation (IBP) rate was 2.10 times higher in patients using glucagon-like peptide-1 receptor agonists (GLP-1RAs) compared to controls.

GLP-1RA users experienced a higher rate of inadequate bowel preparation.
The odds ratio for IBP in the GLP-1RA group was 2.10, indicating a significant increase in risk.
The Boston Bowel Preparation Scale score was lower in the GLP-1RA group, with a mean difference of -0.34.
These findings suggest a potential negative impact of GLP-1RAs on bowel preparation quality.

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INTRODUCTION: The impact of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on colonoscopy bowel preparation is unclear.

METHODS: We searched multiple databases for studies comparing bowel preparation quality between GLP-1RA users and the control group. Using a random-effects model, we calculated pooled odds ratios and mean differences with 95% confidence intervals (CIs). Inadequate bowel preparation (IBP) rate was the primary outcome, and Boston Bowel Preparation Scale mean score was the secondary outcome.

RESULTS: Five studies with 10,833 patients (n = 5,434 GLP-1RAs vs n = 5,399 control) were included. The IBP rate was higher in the GLP-1RAs group compared with the control group (odds ratios 2.10, 95% CI 1.41-3.13, P = 0.0003). Furthermore, the mean Boston Bowel Preparation Scale score was lower in the GLP1-RAs group compared with the control group (mean differences -0.34; 95% CI -0.51, -0.17; P = 0.0001).

DISCUSSION: Our findings suggest that using GLP-1RA increases the risk of IBP.

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