Effects of glucagon-like peptide-1 receptor agonists on gastric mucosal visibility and retained gastric contents during EGD

Gastrointest Endosc. 2024 Nov;100(5):923-927. doi: 10.1016/j.gie.2024.05.012. Epub 2024 May 15.

Abstract

Background and aims: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used in diabetes and obesity management. Although GLP-1RAs delay gastric emptying, their impact on visibility during EGD remains uncertain.

Methods: A 1:1 matched case-control study was conducted. Individuals undergoing EGD who were taking GLP-1RAs were matched to nonusers based on demographic characteristics and diabetes status. A validated scale (POLPREP) was used to determine gastric mucosal visibility scores.

Results: A total of 84 pairs (N = 168) were included. GLP-1RA users had significantly lower visibility scores, with a 2.42 times higher likelihood of lower scores compared with nonusers. In addition, GLP-1RA users had a higher incidence of retained gastric contents (13.1% vs 4.8%; adjusted odds ratio, 4.62; P = .025) and aborted procedures due to this issue. No anesthesia-related adverse events were observed.

Conclusions: GLP-1RA use at the time of endoscopy exhibited higher odds of lower gastric mucosal visibility scores, retained contents, and aborted procedures. Further research is warranted.

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Endoscopy, Digestive System / methods
  • Exenatide / pharmacology
  • Female
  • Gastric Mucosa* / drug effects
  • Gastrointestinal Contents
  • Glucagon-Like Peptide-1 Receptor Agonists*
  • Glucagon-Like Peptides / analogs & derivatives
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Immunoglobulin Fc Fragments
  • Liraglutide / pharmacology
  • Male
  • Middle Aged
  • Recombinant Fusion Proteins

Substances

  • Exenatide
  • Liraglutide
  • dulaglutide
  • Hypoglycemic Agents
  • semaglutide
  • Glucagon-Like Peptides
  • Glucagon-Like Peptide-1 Receptor Agonists
  • Immunoglobulin Fc Fragments
  • Recombinant Fusion Proteins