Singh Sahib, Rahman Syed Hamaad, Khan Nihal, Rajagopal Anjali, Shafique Nouman, Tawde Poonam, Bhardwaj Vaishali, Suresh Kumar Vishnu Charan, Aswath Ganesh, Inamdar Sumant, Dutta Sudhir, Hurairah Abu, Mohan Babu P
Department of Internal Medicine, Sinai Hospital of Baltimore, Baltimore, Maryland, USA.
Department of Internal Medicine, Methodist Dallas Medical Center, Dallas, Texas, USA.
Gastrointest Endosc. 2025 Feb;101(2):343-349.e5. doi: 10.1016/j.gie.2024.10.011. Epub 2024 Oct 12.
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are known to cause delayed gastric emptying; however, the effect on clinical outcomes during upper endoscopy and colonoscopy remains unclear. We conducted a meta-analysis to reconcile the data.
Online databases were searched for studies evaluating GLP-1RAs versus a control group (no GLP-1RAs) in patients undergoing endoscopy. The outcomes of interest were rate of retained gastric contents (RGCs), aborted procedures, aspiration events, and subjective bowel preparation quality. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a random-effects model.
Twenty-three studies with 77,152 patients (4449 in the GLP-1RA arm and 72,703 in the control arm) were included. Mean patient age ranged from 47.6 to 72 years, and 58.4% were women. As compared with the control group, the GLP-1RA group had higher odds of RGCs (OR, 15.39; 95% CI, 4.65-50.99; P < .01) and aborted procedures (OR, 13.86; 95% CI, 4.42-43.43; P < .01). No significant differences were observed between the 2 groups in terms of aspiration events (OR, 21.06; 95% CI, .13-3379.01; P = .24) and subjective bowel preparation quality (OR, .94; 95% CI, .67-1.31; P = .83).
Although statistical significance was reached in terms of visible RGCs and early termination of endoscopies in patients on GLP-1RAs, these events were overall rare. GLP-1RAs do not appear to pose significant risk, as the odds of developing aspiration were comparable in the 2 groups.
已知胰高血糖素样肽-1受体激动剂（GLP-1RAs）会导致胃排空延迟；然而，其对上消化道内镜检查和结肠镜检查期间临床结局的影响仍不明确。我们进行了一项荟萃分析以整合数据。
检索在线数据库，查找评估接受内镜检查患者中GLP-1RAs与对照组（未使用GLP-1RAs）的研究。感兴趣的结局包括胃内容物残留率（RGCs）、检查中止、误吸事件以及主观肠道准备质量。采用随机效应模型估计合并比值比（OR）和95%置信区间（CI）。
纳入了23项研究，共77152例患者（GLP-1RA组4449例，对照组72703例）。患者平均年龄在47.6至72岁之间，58.4%为女性。与对照组相比，GLP-1RA组胃内容物残留的几率更高（OR，15.39；95%CI，4.65 - 50.99；P <.01），检查中止的几率也更高（OR，13.86；95%CI，4.42 - 43.43；P <.01）。两组在误吸事件（OR，21.06；95%CI，.13 - 3379.01；P =.24）和主观肠道准备质量方面未观察到显著差异（OR，.94；95%CI，.67 - 1.31；P =.83）。
尽管使用GLP-1RAs的患者在可见胃内容物残留和内镜检查提前终止方面达到了统计学显著性，但这些事件总体上很少见。由于两组发生误吸的几率相当，GLP-1RAs似乎不会带来重大风险。
