P4471 - Glucagon-Like Peptide-1 Receptor Agonists Are Not Associated With Higher Risk of Intubation or Aspiration Pneumonia in Patients Who Underwent ERCP: A National Cohort Study

Khaled Alsabbagh Alchirazi, MD¹, Mahmoud Y. Madi, MD², Ahmed El Telbany, MD, MPH³, Marina Kim, MD², Tarek Sawas, MD^4
1Aurora Healthcare, Brookfield, WI; ²SSM Health Saint Louis University Hospital, St. Louis, MO; ³University of New Mexico, Albuquerque, NM; ⁴UT Southwestern, Coppell, TX

Introduction: The glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely recognized for their efficacy in glucose regulation, weight loss and anti-inflammatory effects that have the potential to decrease overall mortality. Endoscopic Retrograde Cholangiopancreatography (ERCP) is a crucial procedure for managing a multitude of common pancreaticobiliary conditions. GLP -1 RA use is becoming more prevalent and guidance on the management of GLP-1 RA in the perioperative period is necessary. This is the first study to explore ERCP outcomes in patients using GLP-1 RAs.

Methods: We conducted a retrospective cohort study using large population-based data from the TriNetX platform. We included patients who underwent ERCP and were on GLP-1 RAs between 2018-2024. This cohort of patients was matched with patients who did not receive GLP-1 RAs according to demographics, comorbidities, obesity, BMI, anesthesia medications and confounders that could affect gut motility or aspiration risks using 1:1 propensity score matching (PSM). Primary outcomes included the risk of post-ERCP pancreatitis (PEP), aspiration pneumonia and intubation within 30 days of undergoing ERCP

Results: Before matching, patients who underwent ERCP and were on GLP-1 RAs were at age 60.1 +/- 14.1, white 69.9%, female 54.6%, had higher comorbidities and BMI, table 1. After PSM, we had 3,862 patients in both cohorts. Our study revealed a significantly lower risk of intubation (HR 0.55, 95% CI [0.32-0.93]) and all-cause mortality (HR 0.48, [0.36-0.64]), among patients who underwent ERCP and were on GLP-1 RAs compared to those who were not. There were no statistically significant differences between the two cohorts in the rates of aspiration pneumonia (HR 0.83, [0.53-1.30]) or PEP (HR 0.90, [0.67-1.23]). Figure 1.

Discussion: In our retrospective cohort study, we found that patients on GLP-1RAs were not at a higher risk of developing aspiration pneumonia or requiring emergent intubation compared to patients not on GLP-1RAs. These patients were also not at a higher risk of developing PEP within 30 days of undergoing ERCP. Interestingly, we found that patients on GLP-1RAs had lower rates of all-cause mortality compared to patients not on GLP-1RAs. These findings suggest that the impact of GLP-1RAs might reduce mortality through their anti-inflammatory properties. While these results are promising, further research is necessary to verify the presence of a causal effect and to evaluate the potential benefits of GLP-1RAs in this clinical context.





Disclosures:


Khaled Alsabbagh Alchirazi, MD¹, Mahmoud Y. Madi, MD², Ahmed El Telbany, MD, MPH³, Marina Kim, MD², Tarek Sawas, MD⁴. P4471 - Glucagon-Like Peptide-1 Receptor Agonists Are Not Associated With Higher Risk of Intubation or Aspiration Pneumonia in Patients Who Underwent ERCP: A National Cohort Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.