P4871 - Investigation of Combined Effects of Glucagon-Like Peptide-1 Receptor Agonists With Bariatric Procedures for Weight Loss: A Propensity-Matched Multi-Network Study

Khushbu Patel, MD¹, Sydney Donohue, MD¹, Akash Khurana, MD², Elleson G. Harper, BS¹, Jaime A. Perez, PhD³, Andrew Catanzaro, MD^4
1University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH; ²Cleveland Clinic, Cleveland, OH; ³University Hospitals Clinical Research Center, Cleveland, OH; ⁴Digestive Health Institute, University Hospitals Cleveland Medical Center, Cleveland, OH

Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are being widely utilized for weight reduction. Bariatric procedures are alternatively used for the treatment of obesity. This study aims to analyze the additive effects of GLP-1 RAs with bariatric procedures compared to patients who undergo only bariatric procedures for weight loss.

Methods: A retrospective study was performed using TriNetX, a de-identified database with data from 89 healthcare organizations. We identified all patients ≥18 years, after the FDA approval of GLP-1 RAs for weight loss in 2015, who underwent a bariatric procedure using the CPT code 1007385. The patients were stratified into two groups based on concomitant use of GLP-1 RAs for 6 months to 1 year post-procedure (i.e. Dulaglutide, Semaglutide, Tirzepatide, and Liraglutide). For the two groups, propensity score matching was performed based on demographics, comorbidities, and body mass index (BMI) classes (BMI 25-29.90 kg/m², 30-39.90 kg/m², and >40 kg/m²). To qualify for a bariatric procedure, one of the requirements entails having a BMI >40 kg/m², which is the baseline requirement for our study. We then analyzed the change in BMI from 40 kg/m² as the outcome of interest. Baseline differences were calculated using independent t-tests and chi-square tests. Odds ratios (OR) and 95% confidence intervals (Cl) were calculated to describe the risks.

Results: A total of 35,386 patients who underwent a bariatric procedure were identified. 5,113 were on a GLP-1 RA after the procedure (Group 1) compared to 30,273 patients who were not (Group 2). After propensity score matching, 5,110 patients were in each cohort. Only 16.9% of people were on a GLP-1 RA after a bariatric procedure. Group 1 had an average BMI of 40.1 kg/m² while Group 2 had an average BMI of 46.4 kg/m² post-procedure (p< 0.0001) (Figure 1). Fewer patients in Group 1 on GLP-1 RAs had a BMI < 40 kg/m²compared to Group 2 patients not on GLP-1 RAs (OR 0.417, p-Value < 0.0001). However, there was no statistically significant difference in a post-procedure BMI >40 kg/m² between the two cohorts (Figure 2).

Discussion: Based on this data, GLP-1 RA use is not common in patients who undergo a bariatric procedure. Bariatric procedures alone may be more effective for weight loss reduction in patients with BMI >40 kg/m² compared to simultaneous supplementation with GLP-1 RAs. Further studies should delve into the impact of GLP-1 RA on weight loss and the optimal duration of use after a bariatric procedure.



Disclosures:


Khushbu Patel, MD¹, Sydney Donohue, MD¹, Akash Khurana, MD², Elleson G. Harper, BS¹, Jaime A. Perez, PhD³, Andrew Catanzaro, MD⁴. P4871 - Investigation of Combined Effects of Glucagon-Like Peptide-1 Receptor Agonists With Bariatric Procedures for Weight Loss: A Propensity-Matched Multi-Network Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.