Quality of bowel preparation for colonoscopy in patients on glucagon-like peptide-1 receptor agonists

Background and aims: We aimed to assess the quality of bowel preparation in a matched cohort of patients actively using and not using glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in a large health system in the United States.

Methods: We performed a retrospective review of adult patients undergoing colonoscopy in 22 endoscopy units across 18 sites in the United States.

Results: Our cohort comprised 6235 patients (3344 case patients and 2891 control patients). Baseline variables causing suboptimal bowel preparation were setting of procedure (inpatient), sex (male), body mass index (higher), type 2 diabetes mellitus, inflammatory bowel disease, opioid medications, heart failure, and cirrhosis. Total Boston Bowel Preparation Scale was significantly higher in control patients even after controlling for the mentioned variables (P < .01). Case patients were significantly more likely to meet the definition of inadequate bowel preparation. There was no significant difference between different classes of GLP-1 RAs.

Conclusions: Patients using GLP-1 RAs are more likely to have inadequate bowel preparation during colonoscopy, even accounting for other comorbidities.