Effects of glucagon-like peptide-1 receptor agonists on endoscopy outcomes: systematic review and meta-analysis

🥉 Top 5% JournalOct 14, 2024Gastrointestinal endoscopy

Glucagon-like peptide-1 receptor agonists and their impact on endoscopy results: a systematic review and meta-analysis

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Abstract

Patients on GLP-1 receptor agonists had 15.39 times higher odds of retained gastric contents during endoscopy.

The GLP-1RA group showed significantly higher odds of aborted procedures (OR, 13.86; 95% CI, 4.42-43.43; P < .01) compared to the control group.
No significant difference was found in aspiration events between the GLP-1RA and control groups (OR, 21.06; 95% CI, .13-3379.01; P = .24).
Subjective bowel preparation quality did not differ significantly between the two groups (OR, .94; 95% CI, .67-1.31; P = .83).
Retained gastric contents and aborted procedures were rare overall among patients receiving GLP-1RAs.

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BACKGROUND AND AIMS: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are known to cause delayed gastric emptying; however, the effect on clinical outcomes during upper endoscopy and colonoscopy remains unclear. We conducted a meta-analysis to reconcile the data.

METHODS: Online databases were searched for studies evaluating GLP-1RAs versus a control group (no GLP-1RAs) in patients undergoing endoscopy. The outcomes of interest were rate of retained gastric contents (RGCs), aborted procedures, aspiration events, and subjective bowel preparation quality. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a random-effects model.

RESULTS: Twenty-three studies with 77,152 patients (4449 in the GLP-1RA arm and 72,703 in the control arm) were included. Mean patient age ranged from 47.6 to 72 years, and 58.4% were women. As compared with the control group, the GLP-1RA group had higher odds of RGCs (OR, 15.39; 95% CI, 4.65-50.99; P < .01) and aborted procedures (OR, 13.86; 95% CI, 4.42-43.43; P < .01). No significant differences were observed between the 2 groups in terms of aspiration events (OR, 21.06; 95% CI, .13-3379.01; P = .24) and subjective bowel preparation quality (OR, .94; 95% CI, .67-1.31; P = .83).

CONCLUSIONS: Although statistical significance was reached in terms of visible RGCs and early termination of endoscopies in patients on GLP-1RAs, these events were overall rare. GLP-1RAs do not appear to pose significant risk, as the odds of developing aspiration were comparable in the 2 groups.

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