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Peri-Procedural Safety of GLP-1 Receptor Agonists in Elective Endoscopy: A Multicenter Retrospective Cohort Study

  • 0Department of Internal Medicine, University of Central Florida College of Medicine, Orlando, FL 32827, USA.
Journal of Clinical Medicine +

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September 13, 2025

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September 13, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) do not increase periprocedural complications in elective endoscopy. This study found no increased aspiration risk, with GLP-1 RA users showing fewer oxygen requirements and shorter hospital stays.

Area Of Science

  • Gastroenterology
  • Endocrinology
  • Clinical Pharmacology

Background

  • Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are known to delay gastric emptying.
  • This effect raises concerns regarding the periprocedural safety of elective endoscopic procedures.

Purpose Of The Study

  • To evaluate the association between pre-procedural GLP-1 RA use and post-procedural complications in patients undergoing endoscopy.
  • Specifically investigating the risk of aspiration pneumonia and other adverse events.

Main Methods

  • Retrospective cohort study of adult patients undergoing outpatient esophagogastroduodenoscopy or colonoscopy.
  • Patients were categorized as GLP-1 RA users (n=953) or non-users (n=3289).
  • Outcomes included aspiration, oxygen requirement, hypotension, hospitalization, ICU admission, length of stay, and mortality, adjusted for confounders and anesthesia type.

Main Results

  • No aspiration events were observed in either group.
  • GLP-1 RA use was associated with significantly lower odds of post-procedural oxygen requirement and mortality, and a shorter hospital stay.
  • Hypotension and ICU admission rates were similar; however, GLP-1 RA users under monitored anesthesia care/moderate sedation (MAC/MS) had higher hospitalization odds compared to general anesthesia (GA).

Conclusions

  • Pre-procedural GLP-1 RA therapy is not associated with increased peri-procedural complications in elective endoscopy.
  • While MAC/MS anesthesia in GLP-1 RA users showed higher hospitalization rates, other significant adverse outcomes were not increased.
  • Further prospective research is warranted to elucidate the implications of anesthesia choice in this patient population.

Keywords:

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