P3646 - Impact of Glucagon-Like Peptide-1 Receptor Agonist (GLP-1 RA) on Bowel Preparation for Colonoscopy: A Systematic Review and Meta-Analysis

Syed Hamaad Rahman, DO¹, Nihal I. Khan, MD², Nouman Shafique, MD², Mahir Qureshi, MD³, Islam Mohamed, MD⁴, Rami Musallam, MD⁵, Hamza T. Akram, MBBS⁶, Abu Hurairah, MD^2
1Methodist Dallas Medical Center, Irving, TX; ²AdventHealth Medical Group, AdventHealth, Orlando, FL; ³Cooper University Hospital, Philadelphia, PA; ⁴University of Missouri - Kansas City School of Medicine, Kansas City, MO; ⁵Case Western Reserve University, Cleveland, OH; ⁶District Headquarter Teaching Hospital, Sargodha, Punjab, Pakistan

Introduction: GLP-1 RAs decrease the motility of the GI tract, with recent studies showing conflicting evidence regarding the impact of using GLP-1 RAs prior to colonoscopy. Some studies indicate there may be an association between GLP-1 RA use and poor bowel preparation. Other studies however do not show this association. We conducted a meta-analysis to further elucidate these results.

Methods: A systematic review of the literature from MEDLINE, EMBASE and Scopus was conducted from inception to June 2024, for studies reporting on the use of GLP-1 RAs prior to colonoscopy. Outcomes of interest were Boston Bowel Preparation Scale (BBPS), subjective bowel preparation quality, adverse effects, and need for repeat colonoscopy. Standard meta-analysis methods were followed using the random-effects model. Heterogeneity was assessed using the I2% statistics.

Results: 7 studies were included; 5 retrospective, 2 prospective, 3 multi-center, and 4 single-center. 1 study (Yao et. al.) was excluded from BBPS pooled analysis due to an overlapping cohort (with Tome et. al.). 8,175 patients total were included, 3,983 cases and 4,073 controls. Polyethylene glycol solutions were the most commonly reported bowel preparation solution used. 4 studies showed lower BBPS scores for patients in the GLP-1 RA group, with 2 studies not reporting on BBPS usage. Pooled analysis could not be performed on BBPS scores due to lack of statistical data provided in these studies. Results summarized in Table 1. 3 studies reported on subjective quality assessment of bowel preparation for each patients in each group. Pooled analysis did not show any statistically significant difference in subjective adequacy of bowel preparation between GLP-1 RA and non-GLP-1 RA groups (OR=0.94 [0.67; 1.31], p=0.83). Forrest plot shown in Figure 1. 2 studies reported on the need for repeat colonoscopy, but only 1 study (Yao et. al. 2024) had a statistically significant difference.

Discussion: Our study shows that there is no statistically significant difference in subjective quality of bowel preparation between patients on GLP-1 RAs and those not. There was however a lower reported BBPS in patients taking GLP-1 RAs compared to the control group. One study indicated that use of GLP-1 RA resulted in a statistically significant increase in need for repeat colonoscopy; however this was not seen in other studies. Further prospective, large sample, cohort studies are needed to further clarify the impact of GLP-1 RAs on bowel preparation prior to colonoscopy.



Disclosures:


Syed Hamaad Rahman, DO¹, Nihal I. Khan, MD², Nouman Shafique, MD², Mahir Qureshi, MD³, Islam Mohamed, MD⁴, Rami Musallam, MD⁵, Hamza T. Akram, MBBS⁶, Abu Hurairah, MD². P3646 - Impact of Glucagon-Like Peptide-1 Receptor Agonist (GLP-1 RA) on Bowel Preparation for Colonoscopy: A Systematic Review and Meta-Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.