Changes in Glucagon-Like Peptide-1 Receptor Agonist (GLP-1 RA) Exposures Following Recent Demand for Weight Management: A Retrospective Review of California Poison Control System Data.

Background: 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. Methods: 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). Results: 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]; P < 0.001) and an increase in hospital utilization from exposures of 0.351 per month ([CI = 0.159, 0.544]; P = 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%). Conclusion: 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.