GLP-1 Agonist Medications and Endoscopy: GI Specialists Issue Statement

In their statement, the GI specialists noted that they are familiar with safety issues regarding endoscopy in patients with gastroparesis.

More data are needed so that informed decisions can be made on how to appropriately adjust glucagon-like peptide-1 (GLP-1) receptor agonist treatment prior to upper gastrointestinal (GI) endoscopy, according to a statement issued by multiple GI associations.

The use of GLP-1 receptor agonists for diabetes treatment and weight loss management has been associated with adverse GI effects such as nausea, vomiting and delayed gastric emptying. The medication class includes dulaglutide, exenatide, liraglutide, lixisenatide. semaglutide, and tirzepatide.

Anecdotal reports have suggested that delayed gastric emptying may increase the risk of regurgitation and pulmonary aspiration of gastric contents during sedation. Because of this concern, the American Society of Anesthesiologists issued guidance on preoperative management of patients on GLP-1 receptor agonists.

In response to these concerns, the AASLD, ACG, ASGE, and NASPGHAN issued their own statement regarding the performance of endoscopy in patients taking GLP-1 receptor agonists. In the absence of sufficient evidence, the GI groups suggest that health care providers “exercise best practices when performing endoscopy on these patients on GLP-1 receptor agonists.”

They also called for more data and encouraged key stakeholders to work together to develop the necessary evidence to provide guidance for these patients prior to elective endoscopy.

This article originally appeared on MPR

References:

  1. GI Multi-Society Statement Regarding GLP-1 Agonists and Endoscopy. American Gastroenterological Association. News release. August 11, 2023. https://www.prnewswire.com/news-releases/gi-multi-society-statement-regarding-glp-1-agonists-and-endoscopy-301898265.html.
  2. American Society of Anesthesiologists consensus-based guidance on preoperative management of patients (adults and children) on glucagon-like peptide-1 (GLP-1) receptor agonists. American Society of Anesthesiologists (ASA) Task Force on Preoperative Fasting. News release. June 29, 2023. Accessed August 11, 2023. https://www.asahq.org/about-asa/newsroom/news-releases/2023/06/american-society-of-anesthesiologists-consensus-based-guidance-on-preoperative.