P4103 - Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RAs) and Upper Endoscopy: A Real World Experience

Tuesday, October 29, 2024

10:30 AM – 4:00 PM ET

Location: Exhibit Hall E

Has Audio

Presenting Author(s)

Noppachai Siranart, MD

Brigham and Women's Hospital
Boston, MA

Noppachai Siranart, MD¹, Christopher C.. Thompson, MD, MSc², Pichamol Jirapinyo, MD, MPH³
¹Brigham and Women's Hospital, Boston, MA; ²Brigham and Women's Hospital, Harvard Medical School, Boston, MA; ³Brigham and Women's Hospital, Boston, MA

Introduction: The marked increase in the utilization of glucagon-like peptide-1 receptor agonists (GLP-1RAs) has raised concerns about their safety during endoscopy, due to their mechanism of delaying gastric emptying. This study aims to evaluate the impact of GLP-1RA use on the technical success and safety of esophagogastroduodenoscopy (EGD).

Methods: This was a retrospective study of bariatric patients who underwent EGD between January 2022 and December 2023. Only patients on GLP-1RAs were included, categorized into two groups—those who held the GLP-1RA prior to EGD (GLP-HELD) and those who did not (GLP-CONTINUED). The primary outcome was technical success, defined as the completion of EGD without interruption. Secondary outcomes included the presence and amount of retained gastric contents during EGD, and aspiration rates.

Results: A total of 629 patients were included (Table 1). Baseline age and BMI were 54.9±13.0 years and 37.3±8.0 kg/m². The most commonly prescribed GLP-1RAs were dulaglutide (44%), semaglutide (39%), and liraglutide (15%). Of the 629 patients, 146 (23%) were in the GLP-HELD group and 483 (77%) were in the GLP-CONTINUED group. Primary Outcome: The rates of early termination of EGD were similar between the two groups (1.4% for GLP-CONTINUED vs 0% for GLP-HELD, p=0.36) (Figure 1). Secondary Outcomes: The incidences of retained gastric contents were similar between the two groups (6.4% for GLP-CONTINUED vs 2.7% for GLP-HELD, p=0.09) . There were no aspiration events in either group (Figure 1)

Discussion: Continuation of a GLP-1RA was not associated with an increased incidence of retained gastric contents, early procedural termination, or aspiration events.

Figure: Figure 1: Technical Success (A); Retained Gastric Contents (B); Aspiration Events (C) between groups

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:

Noppachai Siranart indicated no relevant financial relationships.

Christopher Thompson: Apollo Endosurgery – Consultant, Grant/Research Support. Bariendo – Consultant, Founder, Owner/Ownership Interest. Boston Scientific – Consultant, Grant/Research Support. Endoquest Robotics – Advisory Committee/Board Member, Consultant, Grant/Research Support. Endosim – Royalties. Enterasense Ltd. – Advisory Committee/Board Member, Consultant, Founder, Owner/Ownership Interest, Stock Options. EnVision Endoscopy – Advisory Committee/Board Member, Consultant, Founder, Owner/Ownership Interest, Stock Options. ERBE – Grant/Research Support. Fractyl – Consultant, Grant/Research Support, Stock Options. Fujifilm – Grant/Research Support. GI Dynamics – Consultant, Grant/Research Support. GI Windows – Advisory Committee/Board Member, Consultant, Founder, Owner/Ownership Interest, Royalties, Stock Options. Lumendi – Grant/Research Support. Medtronic – Advisory Committee/Board Member, Consultant. Olympus – Consultant, Grant/Research Support. USGI Medical – Advisory Committee/Board Member, Consultant, Grant/Research Support. Xenter – Advisory Committee/Board Member, Consultant.

Pichamol Jirapinyo: Apollo Endosurgery – Consultant, Grant/Research Support. Bariendo – Advisory Committee/Board Member, Consultant, Owner/Ownership Interest. Boston Scientific – Consultant, Grant/Research Support. Cook Medical – Consultant. Endosim – Royalties. ERBE – Consultant. Fractyl – Consultant, Grant/Research Support. GI Dynamics – Consultant, Grant/Research Support. Madrigal – Consultant. Spatz – Consultant. USGI Medical – Consultant, Grant/Research Support.

Noppachai Siranart, MD¹, Christopher C.. Thompson, MD, MSc², Pichamol Jirapinyo, MD, MPH³. P4103 - Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RAs) and Upper Endoscopy: A Real World Experience, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.