Gastrointestinal Adverse Events in Patients Taking GLP-1 Agonists for Weight Loss

When used to manage diabetes, glucagon-like peptide-1 (GLP-1) agonists confer excess risk for adverse gastrointestinal (GI) events, including pancreatitis, biliary disease, bowel obstruction, and gastroparesis. In this study, researchers looked at risk for adverse GI events in 4800 patients who used liraglutide and semaglutide for weight loss (i.e., who had a diagnosis of obesity without a diagnosis of diabetes in a U.S. national health claims database). This cohort was compared with 650 patients who also had diagnosis codes for obesity but not diabetes and who used bupropion-naltrexone for weight loss.

During median follow-up of ≈1 year, adjusted hazard ratios for pancreatitis, bowel obstruction, and gastroparesis all were significantly higher among patients who used GLP-1 agonists than among those who used bupropion-naltrexone (9.1, 4.2, and 3.7, respectively); biliary disease was similar in both cohorts. Among the nearly 90% of GLP-1 patients who were receiving liraglutide, excess incidence of pancreatitis and bowel obstruction were about 7 per 1000 patient-years and 6 per 1000 patient-years, respectively. … [read more]