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Glucagon-Like Peptide Receptor Agonists Use Before Endoscopy Is Associated With Low Retained Gastric Contents: A
Jennifer Phan1, Patrick Chang1, Danny Issa2
1Keck Hospital of USC, Los Angeles, California, USA.
The American Journal of Gastroenterology
|July 17, 2024
Summary
Glucagon-like peptide receptor agonists (GLP1-RAs) show low rates of gastric retention during endoscopy, primarily in patients with type 2 diabetes. An individualized approach to preoperative holding of GLP1-RAs is suggested, rather than universal discontinuation.
Area of Science:
- Gastroenterology
- Endocrinology
- Anesthesiology
Background:
- Conflicting guidelines exist regarding preoperative holding of glucagon-like peptide receptor agonists (GLP1-RAs) before endoscopy.
- The rising use of GLP1-RAs necessitates clarification on their impact on gastric contents during procedures.
Purpose of the Study:
- To evaluate the effect of GLP1-RAs on gastric retention during upper endoscopy.
- To compare outcomes based on adherence to American Society of Anesthesiologist (ASA) preoperative holding guidance.
Main Methods:
- Multicenter cross-sectional study of 815 patients on GLP1-RAs undergoing endoscopy (2021-2023).
- Data collected included demographics, GLP1-RA management, and procedure outcomes.
- Multivariable logistic regression analyzed factors associated with retained gastric contents.
Main Results:
- 8.7% of patients had retained gastric contents, predominantly those with type 2 diabetes mellitus.
- Holding GLP1-RAs per ASA guidance was associated with less retained gastric contents (4.4% vs 12.7%).
- No significant differences were observed in intubation or procedure abortion rates due to gastric retention.
Conclusions:
- Retained gastric contents during endoscopy in patients on GLP1-RAs are infrequent.
- Findings support an individualized preoperative management strategy for GLP1-RAs, considering patient-specific factors like glycemic control (HbA1C).
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