Glucagon‐like peptide‐1 receptor agonists and upper endoscopy: a real‐world experience

🎖️ Top 10% JournalJan 7, 2025Obesity (Silver Spring, Md.)

Use of Glucagon-like Peptide-1 Drugs and Upper Endoscopy Procedures: Real-World Observations

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Abstract

A total of 629 bariatric patients were evaluated for the impact of glucagon-like peptide-1 receptor agonists on endoscopy outcomes.

Technical success rates for esophagogastroduodenoscopy were similar between patients who held glucagon-like peptide-1 receptor agonists prior to the procedure and those who continued them.
The early termination rate of esophagogastroduodenoscopy was 1.4% for the group that continued glucagon-like peptide-1 receptor agonists and 0% for the group that held them.
The incidence of residual gastric contents during the procedure was 6.4% in the continued glucagon-like peptide-1 receptor agonist group and 2.7% in the held group.
No aspiration events were reported in either group during the esophagogastroduodenoscopy.

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OBJECTIVE: Increased use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) has raised safety concerns during endoscopy due to their mechanism of delaying gastric emptying. This study aims to evaluate the impact of GLP-1RAs on technical success and safety of esophagogastroduodenoscopy (EGD).

METHODS: This was a retrospective study of bariatric patients who underwent EGD between January 2022 and December 2023. Only patients on GLP-1RAs were included and were categorized into those who held GLP-1RAs prior to EGD (GLP-HELD group) and those who did not (GLP-CONTINUED group). The primary outcome was technical success, defined as completion of EGD without interruption. Secondary outcomes included the presence of residual gastric contents during EGD and aspiration rates.

RESULTS: A total of 629 patients were included. Baseline age and BMI were mean (SD) 54.9 (13.0) years and 37.3 (8.0) kg/m, respectively. Of 629 patients, 146 (23%) were in the GLP-HELD group, and 483 (77%) were in the GLP-CONTINUED group. For the primary outcome, rates of early termination of EGD were similar between groups (1.4% for GLP-CONTINUED vs. 0% for GLP-HELD; p = 0.36). For secondary outcomes, incidence of residual gastric contents was similar between groups (6.4% for GLP-CONTINUED vs. 2.7% for GLP-HELD; p = 0.09). There were no aspiration events in either group. 2

CONCLUSIONS: Continuation of GLP-1RAs did not appear to be associated with an increased incidence of residual gastric contents, early procedural termination, or aspiration events.

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