Glucagon-like peptide-1 receptor agonists and impaired gastric emptying: a pharmacovigilance analysis of the US Food and Drug Administration adverse event reporting system.

IF 9.1 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia Pub Date : 2024-11-21 DOI:10.1016/j.bja.2024.10.013

Haoquan Huang, Chuwen Hu, Fan Liu, Fengtao Ji, Yanni Fu, Minghui Cao

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引用次数: 0

Abstract

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) potentially increase the risk of pulmonary aspiration resulting from impaired gastric emptying (IGE). We evaluated the association between GLP-1RAs and IGE using the US Food and Drug Administration Adverse Event Reporting System (FAERS).

Methods: We analysed FAERS data from 2004 Q1 to 2024 Q1, identifying the top 10 drugs linked to IGE and determining the proportion of GLP-1RA use. Disproportionality analysis using the reporting odds ratio was conducted to assess the relative IGE risk for each drug. Logistic regression analysed the impact of age, weight, and sex on IGE risk. Cumulative incidence and time to onset of IGE events were examined using Kaplan-Meier and Weibull shape parameter tests.

Results: Among the top 10 drugs associated with IGE reports, five were GLP-1RAs, accounting for 49.5% (982/1982) of cases. Dulaglutide (odds ratio [OR] 0.97, 95% confidence interval [CI] 0.94-1.00, P=0.033) and semaglutide (OR 0.96, 95% CI 0.94-0.97, P=0.001) showed lower IGE risk with older age. For exenatide, higher weight (OR 0.99, 95% CI 0.98-1.00, P=0.033) and male sex (OR 0.39, 95% CI 0.20-0.68, P=0.033) were associated with lower IGE risk. Median onset times ranged from 40.5 days (semaglutide) to 107.5 days (tirzepatide) from intitiation of therapy. The Weibull shape parameter β was <1 for all GLP-1RAs, indicating a higher IGE risk early in treatment.

Conclusions: GLP-1RAs were notably associated with reports of impaired gastric emptying in the FAERS. Age, weight, and sex were significantly associated with impaired gastric emptying risk for certain GLP-1RAs. IGE events tended to occur early in treatment, with risk diminishing over time. These findings provide valuable references for future research on perioperative safety with GLP-1RAs.

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胰高血糖素样肽-1 受体激动剂与胃排空功能受损：美国食品和药物管理局不良事件报告系统的药物警戒分析。

背景：胰高血糖素样肽-1受体激动剂（GLP-1RA）可能会增加因胃排空受损（IGE）而导致肺吸入的风险。我们利用美国食品药品管理局不良事件报告系统（FAERS）评估了 GLP-1RA 与 IGE 之间的关联：我们分析了 2004 年第一季度至 2024 年第一季度的 FAERS 数据，确定了与 IGE 相关的前 10 种药物，并确定了 GLP-1RA 的使用比例。使用报告几率比进行比例失调分析，以评估每种药物的相对 IGE 风险。逻辑回归分析了年龄、体重和性别对 IGE 风险的影响。采用 Kaplan-Meier 和 Weibull 形状参数检验法对 IGE 事件的累积发生率和发病时间进行了检验：在与IGE报告相关的前10种药物中，有5种是GLP-1RA，占49.5%（982/1982）。杜拉鲁肽（几率比 [OR] 0.97，95% 置信区间 [CI]0.94-1.00，P=0.033）和塞马鲁肽（OR 0.96，95% CI 0.94-0.97，P=0.001）显示，年龄越大，IGE 风险越低。对于艾塞那肽，较高的体重（OR 0.99，95% CI 0.98-1.00，P=0.033）和男性（OR 0.39，95% CI 0.20-0.68，P=0.033）与较低的IGE风险相关。中位发病时间从开始治疗的 40.5 天（塞马鲁肽）到 107.5 天（替唑帕肽）不等。Weibull形状参数β为结论：在 FAERS 中，GLP-1RA 与胃排空受损的报告明显相关。年龄、体重和性别与某些 GLP-1RA 药物的胃排空受损风险显著相关。IGE事件往往发生在治疗初期，随着时间的推移风险逐渐降低。这些发现为今后研究 GLP-1RA 的围手术期安全性提供了宝贵的参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British journal of anaesthesia 医学-麻醉学

CiteScore

13.50

自引率

7.10%

发文量

488

审稿时长

27 days

期刊介绍： The British Journal of Anaesthesia (BJA) is a prestigious publication that covers a wide range of topics in anaesthesia, critical care medicine, pain medicine, and perioperative medicine. It aims to disseminate high-impact original research, spanning fundamental, translational, and clinical sciences, as well as clinical practice, technology, education, and training. Additionally, the journal features review articles, notable case reports, correspondence, and special articles that appeal to a broader audience. The BJA is proudly associated with The Royal College of Anaesthetists, The College of Anaesthesiologists of Ireland, and The Hong Kong College of Anaesthesiologists. This partnership provides members of these esteemed institutions with access to not only the BJA but also its sister publication, BJA Education. It is essential to note that both journals maintain their editorial independence. Overall, the BJA offers a diverse and comprehensive platform for anaesthetists, critical care physicians, pain specialists, and perioperative medicine practitioners to contribute and stay updated with the latest advancements in their respective fields.