Glucagon-like peptide-1 receptor agonists before upper gastrointestinal endoscopy and risk of pulmonary aspiration or discontinuation of procedure: cohort study
Main finding · Pulmonary aspirationResult — go to the resultPooled relative risk 0.98 95% CI 0.73–1.31Authors' conclusion
In this comparative cohort study, no increased risk of pulmonary aspiration during upper gastrointestinal endoscopy was observed among adults with type 2 diabetes using GLP-1 receptor agonists compared with SGLT-2 inhibitors within 30 days of the procedure; however, GLP-1 receptor agonists were associated with a higher risk of discontinuation of endoscopy, possibly owing to a higher risk of retained gastric content.
Study context
- Population
- Adults (≥18 years) with type 2 diabetes undergoing upper gastrointestinal endoscopy
- Participants
- 43,365 adults
- Exposure
- GLP-1 receptor agonist vs SGLT-2 inhibitor
- GLP-1 receptor agonistn = 24,817
- SGLT-2 inhibitorn = 18,537reference
- Outcome
- Pulmonary aspiration (defined using diagnostic codes)
- Follow-up
- Day of or day after endoscopy
Methodological detailscomparative cohort, propensity-score fine stratification weighting, two US commercial healthcare databases
- Comparative cohort
- Propensity-score fine stratification weighting
- Two US commercial healthcare databases
Main finding
Pulmonary aspiration
Pooled relative risk
0.98
95% CI 0.73–1.31
By group
GLP-1 receptor agonist vs SGLT-2 inhibitor
pooled RR 0.98 (95% CI 0.73–1.31)
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | GLP-1 receptor agonist | SGLT-2 inhibitor | Pooled RR (95% CI) | |
|---|---|---|---|---|
| Discontinuation of endoscopy | weighted risk per 1000 people 9.79 per 1000 people | weighted risk per 1000 people 4.91 per 1000 people | 1.99 (1.56–2.53) | |
| 0.20.5125Pooled relative risk (log scale) |
Original publication
Glucagon-like peptide-1 receptor agonists before upper gastrointestinal endoscopy and risk of pulmonary aspiration or discontinuation of procedure: cohort study. BMJ. Published 22 October 2024. doi:10.
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