P3640 - Risk of Diverticular Diseases in Diabetic Patients on Semaglutide, a GLP-1 Agonist. A Retrospective Cohort Study Utilizing Big Data and Propensity Score Matching

Rashid Abdel-Razeq, MD¹, Mohamad-Noor Abu-Hammour, MD², Aravinthan Vignarajah, MD³, Maysarah Jamil. Qapaja, MS⁴, Kamal Hassan, MD⁵, Prabhat Kumar, MD³, Islam B Mohamed, MD³, Barish Eren, MD³, Gianina Flocco, MD^6
1Cleveland Clinic, Cleveland, OH; ²Cleveland Clinic Fairview, Cleveland, OH; ³Cleveland Clinic Foundation, Cleveland, OH; ⁴Cairo University School of Medicine, Cairo, Al Jizah, Egypt; ⁵New York-Presbyterian/Queens, New York, NY; ⁶Cleveland Clinic Foundation, Fairview Park, OH

Introduction: Semaglutide, a Glucagon-Like Peptide-1 (GLP-1) agonist, is widely used to treat both diabetes mellitus and obesity. Semaglutide is known to result in various gastrointestinal adverse events. The safety of GLP-1 agonists in diabetic patients with diverticular diseases is not studied, but occasionally encountered in clinical practice. This study aims to evaluate and compare the incidence of diverticular diseases; both symptomatic (diverticulitis) and asymptomatic (diverticulosis) in non-obese diabetic patients treated with semaglutide.

Methods: A retrospective cohort study was conducted using data from the TriNetX network. The study population include patients aged ≥ 18 years, with diabetes mellitus, non-obese (BMI < 30 kg/m2), who are treated with (Cohort-1) or without (Cohort-2) semaglutide. Patients included were followed for up to two years post-semaglutide initiation to identify the incidence of diverticular diseases. Relevant variables were extracted and analyzed. Data analyzed was obtained from 123 health care organizations included in the Global Collaborative Network and propensity score matching was performed on all characteristics.

Results: Cohort-1 patients were extracted from 89,447 patients who matched the query criteria (age ≥18 years, with diabetes mellitus, BMI < 30 kg/m² and on semaglutide). Cohort-2 patients were extracted from a total of 2,449,841 similar patients but never treated with GLP-1 agonists. Following propensity score matching, a total of 84,082 participant were identified in each cohort. Patients treated with semaglutide were a little older (mean age 62.1±12.0 years) compared to those without (mean age 61.9±13.3 years), p< 0.001, more hypertensive (67.3% vs. 65.9%), hyperlipidemic (79.8% vs. 77.7%) and with chronic kidney disease (18.0% vs. 17.0%); all with p< 0.001. Diverticulosis and diverticular disease were significantly lower in patients treated with semaglutide (5.4% and 6.0%, respectively) compared to those without semaglutide; 7.1% and 7.8%, respectively (p< 0.001). However, no difference observed in the incidence of diverticulitis in the two groups; 0.86% versus 1.1%, p=0.671 (Table).

Discussion: Adult patients treated with semaglutide for diabetes mellitus are not at higher risk for diverticulitis, and seems to have a lower risk of diverticulosis. Preexisting diverticular diseases, thus, may not contraindicate the use of semaglutide. Similar study on the use of semaglutide for obesity is ongoing.


Disclosures:


Rashid Abdel-Razeq, MD¹, Mohamad-Noor Abu-Hammour, MD², Aravinthan Vignarajah, MD³, Maysarah Jamil. Qapaja, MS⁴, Kamal Hassan, MD⁵, Prabhat Kumar, MD³, Islam B Mohamed, MD³, Barish Eren, MD³, Gianina Flocco, MD⁶. P3640 - Risk of Diverticular Diseases in Diabetic Patients on Semaglutide, a GLP-1 Agonist. A Retrospective Cohort Study Utilizing Big Data and Propensity Score Matching, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.