P0472 - GLP-1 RAs Use is Associated with Lower 7-Days Repeat Esophagogastroduodenoscopy after Index Endoscopy in Patients with Achalasia: A Multi-Center Analysis
Donghyun Ko, MD1, Do Han Kim, MD2, Sharon Narvaez, MD3, Luis Nieto, MD4, Pedro Palacios-Argueta, MD5, Paul Kroner, MD, MSc6, Frank J. Lukens, MD7 1Yale-New Haven Health/Bridgeport Hospital, Bridgeport, CT; 2Mount Sinai Morningside and West, Icahn School of Medicine at Mount Sinai, New York, NY; 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-1RAs) are found to have beneficial effects in other conditions beyond their antidiabetic effect. Although it has minimal side effects, it is known that the use of GLP-1RAs is associated with delayed gastric emptying. This may impact the rate of repeat procedure in patients with an index esophagogastroduodenoscopy (EGD) such as in achalasia. The aim of our study is to determine an association between GLP-1 RAs use and repeat EGD in patients with achalasia.
Methods: A retrospective cohort study was performed using large population-based data from the TriNetX platform. Patients with achalasia and index EGD who have received GLP-1RAs between January 1, 2021, and May 30, 2024, were identified. This group was matched with patients who did not receive GLP-RAs according to age, demographics, comorbidities, and medication by using 1:1 propensity matching. The primary outcome was repeat EGD, and secondary outcomes were other procedures such as esophagogram, esophageal dilation, chest CT, or esophageal stent placement 7 days after the index EGD.
Results: A total of 10,887 adult patients with achalasia and an index upper endoscopy were identified, 480 of these individuals were taking GLP -1RAs; 468 out of 480 (mean [SD] age, 60.9 [12.5] years; 298 [63.7%] female) were matched with 468 individuals (mean [SD] age, 61.6 [14.5] years; 294 [62.8%] female) who did not take GLP-1RAs. The GLP-1RAs group had significantly lower repeat EGD (Odds Ratio [OR], 0.24; 95% Confidence Interval [CI], 0.19-0.32). No significant reductions esophagogram (OR, 0.86; 95% CI, 0.41-1.80), esophageal dilation (OR, 1.02; 95% CI, 0.42-2.48), and chest CT (OR, 1.28; 95% CI, 0.52-3.11) were observed. No patients underwent esophageal stent placement.
Discussion: Throughout this study, we observed that less repeat EGD was needed in patients with achalasia under GLP-1RAs. Despite the possible side effects, beneficial effects such as weight loss and anti-inflammation of GLP-1RAs could have positively impacted to lower the repeat EGD rates. Further studies are required to determine the exact mechanism of this improvement.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Donghyun Ko indicated no relevant financial relationships.
Do Han Kim indicated no relevant financial relationships.
Sharon Narvaez indicated no relevant financial relationships.
Luis Nieto indicated no relevant financial relationships.
Pedro Palacios-Argueta indicated no relevant financial relationships.
Paul Kroner indicated no relevant financial relationships.
Frank J. Lukens indicated no relevant financial relationships.
Donghyun Ko, MD1, Do Han Kim, MD2, Sharon Narvaez, MD3, Luis Nieto, MD4, Pedro Palacios-Argueta, MD5, Paul Kroner, MD, MSc6, Frank J. Lukens, MD7. P0472 - GLP-1 RAs Use is Associated with Lower 7-Days Repeat Esophagogastroduodenoscopy after Index Endoscopy in Patients with Achalasia: A Multi-Center Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
