Incidence of Gastrointestinal Adverse Events and Healthcare Resource Utilization in Patients Using Glucagon-Like Peptide-1 Analogs: A Real-World Study.

IF 2.8 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Digestive Diseases and Sciences Pub Date : 2026-11-01 Epub Date: 2026-07-08 DOI:10.1007/s10620-026-10112-7

Piyush Nathani, Sevag Hamamah, Jena Velji, Harsh K Patel, Rohit Nathani, Dhruvil Radadiya, Aarnav Shandilya, Sachin Srinivasan, Madhav Desai, Alessandro Repici, Cesare Hassan, Prateek Sharma

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引用次数: 0

Abstract

Purpose: Glucagon-like peptide-1 receptor agonists (GLP-1) are widely prescribed for diabetes mellitus (DM) and obesity. Growing concerns about gastrointestinal side effects (GI-AE) prompted this real-world study, to assess the incidence of GI-AEs and the associated healthcare burden in patients on GLP-1 s.

Methods: Using the TriNetX® network with 120 million patient records, patients with DM and obesity were grouped into GLP-1 and control cohorts. Propensity score matching (1:1) was performed using demographics, comorbidities, Hemoglobin-A1c, BMI, and other confounders. Incidence, number needed to harm (NNH), and Cox-proportional hazard ratios (HR) were used to compare outcomes at 1 year.

Results: After matching, 164,987 patients were included in each cohort. At one year, 31.9% of patients on GLP-1 therapy had GI-AEs (NNH 17.2), with incidence of nausea and vomiting, de-novo gastroesophageal reflux disease (GERD), and de-novo gastroparesis being 13%, 8.7%, and 0.7% respectively. GLP-1 use was associated with an increased risk of nausea and vomiting (HR 1.24 [1.21, 1.26]), GERD (HR 1.18 [1.14, 1.22]), proton pump inhibitor use (HR 1.15 [1.12, 1.19]), esophagitis (HR 1.24 [1.19, 1.30]), gastroparesis (HR 1.57 [1.43, 1.73]), drug-induced pancreatitis (HR 2.85 [1.82, 4.48]) and a decreased risk of bowel obstruction (HR 0.86 [0.80, 0.92]). No significant association was seen with cholecystitis (HR 1.10 [0.97, 1.15]) or choledocholithiasis (HR 1.07 [0.94, 1.21]). Esophagogastroduodenoscopy (EGD) utilization (HR 1.25 [1.20, 1.29]) was higher, but emergency room (ER) visits (HR 0.96 [0.95, 0.98]) and hospital admissions (HR 0.92 [0.91, 0.94]) were lower in the GLP-1 cohort.

Conclusion: Nearly one-third of patients with DM and obesity on GLP-1 therapy reported GI-AEs, primarily nausea/vomiting and GERD. Providers should be aware of these events, given their association with increased EGD utilization but not higher ER visits or hospital admissions.

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胰高血糖素样肽-1类似物患者胃肠道不良事件发生率和医疗资源利用：一项现实世界研究

目的：胰高血糖素样肽-1受体激动剂（GLP-1）被广泛用于治疗糖尿病（DM）和肥胖症。对胃肠道副作用（GI-AE）的日益关注促使这项现实世界的研究，以评估GI-AE的发生率和相关的GLP-1患者的医疗负担。方法：利用TriNetX®网络收集1.2亿例患者记录，将糖尿病合并肥胖患者分为GLP-1组和对照组。使用人口统计学、合并症、血红蛋白- a1c、BMI和其他混杂因素进行倾向评分匹配（1:1）。发生率、需要伤害数（NNH）和Cox-proportional hazard ratio （HR）用于比较1年的结果。结果：配对后，每个队列共纳入164987例患者。一年后，31.9%接受GLP-1治疗的患者出现gi - ae (NNH 17.2)，恶心和呕吐、胃食管反流病（GERD）和胃轻瘫的发生率分别为13%、8.7%和0.7%。GLP-1的使用与恶心和呕吐（HR 1.24[1.21, 1.26]）、胃食管反流（HR 1.18[1.14, 1.22]）、质子泵抑制剂（HR 1.15[1.12, 1.19]）、食管炎（HR 1.24[1.19, 1.30]）、胃轻瘫（HR 1.57[1.43, 1.73]）、药物性胰腺炎（HR 2.85[1.82, 4.48]）和肠梗阻风险降低（HR 0.86[0.80, 0.92]）相关。胆囊炎（HR 1.10[0.97, 1.15]）或胆总管结石（HR 1.07[0.94, 1.21]）与胆囊炎无显著相关性。在GLP-1队列中，食管胃十二指肠镜（EGD）使用率（HR 1.25[1.20, 1.29]）较高，但急诊室（ER）就诊（HR 0.96[0.95, 0.98]）和住院（HR 0.92[0.91, 0.94]）较低。结论：近三分之一接受GLP-1治疗的糖尿病和肥胖患者报告gi - ae，主要是恶心/呕吐和反流。提供者应该意识到这些事件，因为它们与EGD使用率的增加有关，但与急诊室就诊或住院率的增加无关。

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

Digestive Diseases and Sciences 医学-胃肠肝病学

CiteScore

6.40

自引率

3.20%

发文量

420

审稿时长

1 months

期刊介绍： Digestive Diseases and Sciences publishes high-quality, peer-reviewed, original papers addressing aspects of basic/translational and clinical research in gastroenterology, hepatology, and related fields. This well-illustrated journal features comprehensive coverage of basic pathophysiology, new technological advances, and clinical breakthroughs; insights from prominent academicians and practitioners concerning new scientific developments and practical medical issues; and discussions focusing on the latest changes in local and worldwide social, economic, and governmental policies that affect the delivery of care within the disciplines of gastroenterology and hepatology.