Glucagon-like peptide-1 receptor agonists and upper endoscopy: a real-world experience

ObjectiveIncreased use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) has raised safety concerns during endoscopy due to their mechanism of delaying gastric emptying. This study aims to evaluate the impact of GLP-1RAs on technical success and safety of esophagogastroduodenoscopy (EGD).MethodsThis was a retrospective study of bariatric patients who underwent EGD between January 2022 and December 2023. Only patients on GLP-1RAs were included and were categorized into those who held GLP-1RAs prior to EGD (GLP-HELD group) and those who did not (GLP-CONTINUED group). The primary outcome was technical success, defined as completion of EGD without interruption. Secondary outcomes included the presence of residual gastric contents during EGD and aspiration rates.ResultsA total of 629 patients were included. Baseline age and BMI were mean (SD) 54.9 (13.0) years and 37.3 (8.0) kg/m2, respectively. Of 629 patients, 146 (23%) were in the GLP-HELD group, and 483 (77%) were in the GLP-CONTINUED group. For the primary outcome, rates of early termination of EGD were similar between groups (1.4% for GLP-CONTINUED vs. 0% for GLP-HELD; p = 0.36). For secondary outcomes, incidence of residual gastric contents was similar between groups (6.4% for GLP-CONTINUED vs. 2.7% for GLP-HELD; p = 0.09). There were no aspiration events in either group.ConclusionsContinuation of GLP-1RAs did not appear to be associated with an increased incidence of residual gastric contents, early procedural termination, or aspiration events.