GLP-1 Agonist Use for Weight Loss and Gastrointestinal Complications
BACKGROUND AND PURPOSE:
- Sodhi et al. (JAMA, 2023) examined gastrointestinal adverse events associated with Glucagon-like peptide 1 (GLP-1) agonists used for weight loss in a clinical setting
METHODS:
- Cohort study
- Population
- A random sample of a large health claims database
- Exposures
- New users of semaglutide or liraglutide
- New users of active comparator bupropion-naltrexone (weight loss agent unrelated to GLP-1 agonists)
- Study design
- Cox proportional hazards regression model was used to estimate hazard ratios (HR)
- Adjustments: Age | Sex | Alcohol use | Smoking | Hyperlipidemia | Abdominal surgery in the previous 30 days | Geographic location
- Primary outcome
- Incidence of biliary disease | Pancreatitis | Bowel obstruction | Gastroparesis
RESULTS:
- Liraglutide: 4144 | Semaglutide: 613 | Bupropion-naltrexone: 654
- Use of GLP-1 agonists compared with bupropion-naltrexone was associated with increased risk of
- Pancreatitis: Adjusted HR 9.09 (95% CI, 1.25 to 66.00)
- Bowel obstruction: HR, 4.22 (95% CI, 1.02 to 17.40)
- Gastroparesis: HR, 3.67 (95% CI, 1.15 to 11.90)
- Use of GLP-1 agonists did not increase the risk of biliary disease
- HR 1.50 (95% CI, 0.89 to 2.53)
- Inclusion of GLP-1 agonists regardless of history of obesity reduced HRs and narrowed CIs but did not change the significance of the results
CONCLUSION:
- The use of GLP-1 agonists for weight loss was linked to an increased risk of pancreatitis, gastroparesis, and bowel obstruction
- The authors state
Given the wide use of these drugs, these adverse events, although rare, must be considered by patients who are contemplating using the drugs for weight loss because the risk-benefit calculus for this group might differ from that of those who use them for diabetes
