P1947 - Glucagon-Like Peptide -1 Receptor agonists significantly affects quality of prep in screening colonoscopies- A private practice experience

Anika Koka, ¹, Alexander Perez, ², Julian Ignacio Perez, BS³, Julian Perez-Barrios, MD^4
1Canterbury School, Fort Myers, FL; ²University of Central Florida, Fort Myers, FL; ³Stanford University, Stanford, CA; ⁴Gastroenterology Associates, Fort Myers, FL

Introduction: Glucagon -like peptide 1 receptor agonists (GLP-1RA) are becoming the most commonly used medication mainly for obesity and diabetes. Given its role in delaying gastrointestinal motility, we hypothesize that it would affect bowel prep quality. History of opioid use was also compared as an independent variable.

Methods: A retrospective review was conducted of 1000 adult patients who underwent a screening colonoscopy at an outpatient surgery center between March 2023 to June of 2024. A split dose regimen was used for all types of preps.Patients were instructed to start their second dose exactly 7 hours prior to their scheduled procedure time and finish within an hour.

Patients were grouped into AM or PM groups.Quality of prep was rated as follows: 1=excellent/good,2=adequate,3=fair,4=poor.Secondary objectives included comparing prep score across age,race,gender,diabetes,BMI,GLP-1RA use and opioid use.

Statistical analysis was performed using R programming language and Bayesian information criteria to find a reduced model which best fit the data. A Welch Two sample T test was performed to test the null hypothesis that the quality of prep is equal between the groups for these different variables.

Results: A total of 438 patients in DAC and 432 in non DAC patients were identified after excluding patients with insufficient data.29 patients were identified as taking GLP-1RA at the time of their colonoscopy. 25 patients were identified as taking opioids at the time of their colonoscopy.There were no statistically significant differences in both groups.The percentage of inadequate bowel prep was 41.37 in the GLP-1RA group and 40 in the opioid group when compared to 7.92 in the control group.There was no statistical difference between the DAC and non DAC patients in both GLP and opioid groups.

The p value when compared for the GLP-1RA group was 0.008 and 0.0017 in the opioid group.

Discussion: The use of GLP-1RA was associated with a statistically significant lower quality of bowel prep compared to the non GLP- 1RA group.The results were similar to the opioid group.This study was done prior to current guidelines of holding GLP-1RA a week prior to the procedure to prevent aspiration.A follow up study to analyze if holding the medication for a week prior is sufficient to improve the quality of bowel prep, or a more aggressive/specific bowel regimen would be required for this subset of patients.



Disclosures:


Anika Koka, ¹, Alexander Perez, ², Julian Ignacio Perez, BS³, Julian Perez-Barrios, MD⁴. P1947 - Glucagon-Like Peptide -1 Receptor agonists significantly affects quality of prep in screening colonoscopies- A private practice experience, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.