P1611 - Risk of De Novo Gastroparesis in Non-Diabetic Patients With Obesity Taking Tirzepatide Versus Semaglutide: A Multi-Center Analysis.

Do Han Kim, MD¹, Donghyun Ko, MD², Sharon Narvaez, MD³, Luis Nieto, MD⁴, Pedro Palacios-Argueta, MD⁵, Paul Kroner, MD, MSc⁶, Frank J. Lukens, MD^7
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; ⁴Emory School of Medicine, Atlanta, GA; ⁵Mayo Clinic Florida, Jacksonville, FL; ⁶Riverside Regional Medical Center, Newport News, VA; ⁷Mayo 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). Tirzepatide, a dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 RA has shown superior efficacy when compared to semaglutide. The aim of this study is to determine the risk of de novo gastroparesis in non-diabetic patients with obesity taking tirzepatide versus semaglutide.

Methods: We performed a retrospective cohort study utilizing large population-based data from the TriNetX platform. All patients with obesity (BMI ≥ 30) who received GLP-1 RAs, specifically tirzepatide or semaglutide, were included between January 1, 2021, and May 30, 2024. Patients with type 2 diabetes mellitus (DM) were excluded. Two cohorts were defined based on the specific GLP-1 RA treatment received. The cohort of patients who received tirzepatide was matched with patients who received semaglutide according to age, demographics, comorbidities, and medication by using 1:1 propensity matching. The primary endpoint was gastroparesis. The secondary outcomes were gastrointestinal side effects, including nausea and vomiting, abdominal pain, diarrhea, constipation. Odds ratio (OR) with 95% confidence intervals were calculated; p-value < 0.05 was considered statistically significant.

Results: The tirzepatide cohort included a total of 17,733 patients, while the semaglutide group included 89,947 patients. After propensity matching 1:1, 17,728 patients were included from each cohort. In the tirzepatide group, the mean age was 46.7 years and 66.9% were female. Similarly, the semaglutide cohort had a mean age of 46.5 years and 67.4% were females. The tirzepatide cohort had significant lower risk of gastroparesis (OR 0.36; 0.17 – 0.73), nausea and vomiting (OR 0.55; 0.48 – 0.62), abdominal pain (OR 0.55; 0.48 – 0.62), diarrhea (OR 0.56; 0.47 – 0.66), and constipation (OR 0.56; 0.48 – 0.65) compared with the semaglutide group.

Discussion: Non-diabetic patients with obesity on tirzepatide have 64% lower risk of de novo gastroparesis when compared to non-diabetic patients with obesity taking semaglutide. Moreover, the rates of gastrointestinal side effects, such as nausea and vomiting, abdominal pain, diarrhea, and constipation are lower in the tirzepatide cohort. Further studies are required to determine the impact of tirzepatide’s dual mechanism in clinical outcomes.




Disclosures:


Do Han Kim, MD¹, Donghyun Ko, MD², Sharon Narvaez, MD³, Luis Nieto, MD⁴, Pedro Palacios-Argueta, MD⁵, Paul Kroner, MD, MSc⁶, Frank J. Lukens, MD⁷. P1611 - Risk of De Novo Gastroparesis in Non-Diabetic Patients With Obesity Taking Tirzepatide Versus Semaglutide: A Multi-Center Analysis., ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.