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

Pichamol Jirapinyo; Noppachai Siranart; Christopher C Thompson

doi:10.1002/oby.24190

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

Obesity (Silver Spring). 2025 Jan 6. doi: 10.1002/oby.24190. Online ahead of print.

Authors

Pichamol Jirapinyo^{1

2}, Noppachai Siranart¹, Christopher C Thompson^{1

2}

Affiliations

¹ Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA.
² Harvard Medical School, Boston, Massachusetts, USA.

PMID: 39763285
DOI: 10.1002/oby.24190

Abstract

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/m², 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.

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.