Ho Raymond Y, Regelman Hsiaoting, Ma Anita, Lee Shu Yi, Sandhu Saveena, Shapiro Sarah, Lewis Justin, Tsutaoka Ben, Apollonio Dorie E
California Poison Control System, University of California San Francisco, San Francisco, CA, USA.
School of Pharmacy, University of California San Francisco, San Francisco, CA, USA.
J Pharm Technol. 2025 May 12:87551225251332212. doi: 10.1177/87551225251332212.
Calls to poison centers involving exposure to glucagon-like peptide-1 receptor agonists (GLP-1 RA) have increased. Data from a statewide poison control system from 2017 to 2023 was analyzed to assess changes in GLP-1 RA exposure frequencies and reported clinical effects. Retrospective records review of all human exposure cases to GLP-1 RA reported to a statewide poison center from December 1, 2017 to December 31, 2023. Collected data were entered into REDCap (Research Electronic Data Capture). Changes in exposure frequency over time assessed with interrupted time series analysis (ITSA); the intervention was FDA approval of semaglutide (Wegovy) for chronic weight management in June 2021. Statistical analyses completed using Stata v17 or OpenEpi (v3.01). One thousand forty-seven cases were included. Interrupted time series analysis identified an increase in reported GLP-1 RA exposures of 1.16 per month ([CI = 0.570, 1.802]; < 0.001) and an increase in hospital utilization from exposures of 0.351 per month ([CI = 0.159, 0.544]; = 0.001) following Wegovy approval. Common adverse effects were nausea (n = 295, 28.0%), vomiting (n = 267, 25.5%), dizziness (n = 63, 6.0%), abdominal pain (n = 54, 5.1%), and other gastrointestinal symptoms (n = 60, 5.7%). Most cases were managed at home (n = 696, 66.5%). Two hundred twenty (21.0%) patients were treated in the emergency department, and 46 (4.4%) were admitted. The most common reason for exposure was unintentional therapeutic error (n = 838, 80.0%). Five major (0.5%) and 72 moderate (6.9%) medical outcomes were reported. Hypoglycemia occurred in 40 (3.8%) patients. Thirty-six exposures involving compounded GLP-1 RA were identified; administration errors were the main reason for exposures among this subgroup (n = 33, 91.7%). Glucagon-like peptide-1 receptor agonist exposures and hospital utilization after exposure increased following Wegovy approval for weight management. Hypoglycemia, while infrequent, was reported; nondiabetic patients using GLP-1 RA should be educated on recognizing hypoglycemia. Additional patient education on GLP-1 RA administration and further study on the impact of compounded GLP-1 RA products are warranted.
涉及接触胰高血糖素样肽-1受体激动剂(GLP-1 RA)的中毒控制中心求助电话有所增加。分析了2017年至2023年全州中毒控制系统的数据,以评估GLP-1 RA接触频率的变化和报告的临床影响。对2017年12月1日至2023年12月31日向全州中毒控制中心报告的所有GLP-1 RA人体接触病例进行回顾性记录审查。收集的数据录入REDCap(研究电子数据采集)。使用中断时间序列分析(ITSA)评估随时间的接触频率变化;干预措施是2021年6月美国食品药品监督管理局(FDA)批准司美格鲁肽(Wegovy)用于慢性体重管理。使用Stata v17或OpenEpi(v3.01)完成统计分析。纳入了1047例病例。中断时间序列分析发现,在Wegovy获批后,报告的GLP-1 RA接触量每月增加1.16例([置信区间=0.570,1.802];P<0.001),因接触导致的医院利用率每月增加0.351例([置信区间=0.159,0.544];P=0.001)。常见不良反应包括恶心(n=295,28.0%)、呕吐(n=267,25.5%)、头晕(n=63,6.0%)、腹痛(n=54,5.1%)和其他胃肠道症状(n=60,5.7%)。大多数病例在家中处理(n=696,66.5%)。220例(21.0%)患者在急诊科接受治疗,46例(4.4%)患者入院。接触的最常见原因是无意的治疗错误(n=838,80.0%)。报告了5例严重(0.5%)和72例中度(6.9%)医疗后果。低血糖发生在40例(3.8%)患者中。识别出36例涉及复方GLP-1 RA的接触;给药错误是该亚组接触的主要原因(n=33,91.7%)。在Wegovy获批用于体重管理后,胰高血糖素样肽-1受体激动剂接触量和接触后的医院利用率增加。低血糖虽不常见,但有报告;应教育使用GLP-1 RA的非糖尿病患者识别低血糖。有必要对GLP-1 RA给药进行更多患者教育,并进一步研究复方GLP-1 RA产品的影响。