P0029 - GLP-1 RA Use is Associated with Lower Risk of Biliary Disease Outcomes in Non-Diabetic Patients with Obesity: A Multi-Center Analysis

Do Han Kim, MD¹, Donghyun Ko, MD², Sharon Narvaez, MD³, Olanrewaju Adeniran, MBBS⁴, Luis Nieto, MD⁵, Miguel Salazar, MD⁶, Pedro Palacios-Argueta, MD⁷, Paul Kroner, MD, MSc⁸, Frank J. Lukens, MD^9
1Mount Sinai Morningside and West, Icahn School of Medicine at Mount Sinai, New York, NY; ²Yale-New Haven Health/Bridgeport Hospital, Bridgeport, CT; ³Universidad de Guayaquil, School of Medicine, Atlanta, GA; ⁴West Virginia University School of Medicine, Morgantown, WV; ⁵Emory School of Medicine, Atlanta, GA; ⁶University of California Riverside, Riverside, CA; ⁷Mayo Clinic Florida, Jacksonville, FL; ⁸Riverside Regional Medical Center, Newport News, VA; ⁹Mayo Clinic, Jacksonville, FL

Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have proven their efficacy in the management of both obesity and type 2 diabetes mellitus (DM). A recent meta-analysis has demonstrated the increased risk of biliary disease, specifically cholecystitis and cholelithiasis, in patients with obesity and diabetes. There is paucity in the literature describing the risk of biliary disease in non-diabetic patients with obesity.

Methods: We performed a retrospective cohort study utilizing large population-based data from the TriNetX platform. We identified non-diabetic patients with obesity (BMI ≥ 30) who received GLP-1 RAs between January 1, 2021, and May 31, 2024. Patients with medications associated with cholecystitis, choledocholithiasis, and pancreatitis were excluded. This cohort of patients was matched with patients who did not receive GLP-1 RAs according to age, demographics, comorbidities, and medications by using 1:1 propensity matching. The primary endpoints were rates of cholecystitis, choledocholithiasis, and cholangitis. The secondary endpoint was all-cause mortality. Odds ratio (OR) with 95% confidence intervals were calculated; p-value < 0.05 was considered statistically significant.

Results: A total of 861,913 adult non-diabetic patients with obesity were identified, out of which 44,101 individuals were taking GLP -1 RAs; 44,100 out of 44,101 patients (mean [SD] age, 44.9 [12.3] years; 28,980 [65.7%] female) were matched with 44,100 patients (mean [SD] age, 45.4 [13.7] years; 29,018 [66.6%] female) who were not on GLP-1 RAs. The GLP-1 RAs group had a significantly lower risk of cholecystitis (OR 0.72; 0.54 – 0.95), gallstone pancreatitis (OR 0.73; 0.62 – 0.85), and all-cause mortality (OR 0.17; 0.11 – 0.24) compared with the non-GLP-1 RAs group. No significant findings in choledocholithiasis (OR, 0.75; 0.56 – 1.02) and cholangitis (OR 1.0; 0.42 – 2.40) were identified.

Discussion: Through this multi-center retrospective study, we demonstrate that non-diabetic patients with obesity on GLP-1 RAs have decreased risk for biliary disease. The risk for cholecystitis, gallstone pancreatitis, and all-cause mortality was 28%, 27%, and 83%, respectively, lower in this cohort compared to non-diabetic non-GLP-1 RA patients with obesity. Further studies are required to determine the mechanism and importance of these findings.


Disclosures:


Do Han Kim, MD¹, Donghyun Ko, MD², Sharon Narvaez, MD³, Olanrewaju Adeniran, MBBS⁴, Luis Nieto, MD⁵, Miguel Salazar, MD⁶, Pedro Palacios-Argueta, MD⁷, Paul Kroner, MD, MSc⁸, Frank J. Lukens, MD⁹. P0029 - GLP-1 RA Use is Associated with Lower Risk of Biliary Disease Outcomes in Non-Diabetic Patients with Obesity: A Multi-Center Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.