GLP-1 RA use was associated with poorer bowel preparation before colonoscopy but not clearly with more repeat colonoscopies.
Evidence
This systematic review and meta-analysis pooled 12 studies with 123,858 patients, including 57,699 GLP-1 RA users, and compared , scores, and repeat colonoscopies.
Caveat
The evidence is based on pooled existing studies and showed no statistically clear association with repeat colonoscopy despite worse preparation metrics.
Simplified
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely prescribed for diabetes and obesity. Recent studies suggest they may negatively affect bowel preparation quality before colonoscopy (CLN), leading to (IBP) and repeat procedures. We conducted a systematic review and meta-analysis to assess this association.
METHODS: PubMed, Embase and Cochrane databases, along with abstracts from Digestive Disease Week 2024 and the American College of Gastroenterology Meeting 2024, were searched. Outcomes included IBP, repeat CLNs, and the mean difference in (BBPS) scores between GLP-1 RA users and non-users. Adjusted odds ratios (OR), for age, sex, body mass index, and diabetes, were pooled.
RESULTS: Twelve studies including 123,858 patients (57,699 GLP-1 RA users) were analyzed. GLP-1 RA use was associated with higher IBP risk (OR, 1.55; 95% CI, 1.11-2.16); adjusted analyses confirmed this (OR, 2.35; 95% CI, 2.02-2.74). BBPS scores were lower among GLP-1 RA users (mean difference, -0.68; 95% CI, -0.77 to -0.58). No association with repeat CLNs was observed (OR, 1.5; 95% CI, 0.88-2.56).
CONCLUSIONS: GLP-1 RA use is linked to inadequate bowel preparation but not repeat CLNs. Further prospective studies are warranted to further evaluate this finding.
Key numbers
1.55
Increase in Risk
Odds ratio for among GLP-1 RA users vs. non-users.
-0.68
Mean Score Decrease
Mean difference in scores between GLP-1 RA users and non-users.
1.5
Repeat Colonoscopy Odds Ratio
Odds ratio for repeat colonoscopy in GLP-1 RA users vs. non-users.
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