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Endoscopy 2025; 57(02): 126-133
DOI: 10.1055/a-2419-3875
Original article

Glucagon-like peptide-1 receptor agonists significantly affect the quality of bowel preparation for colonoscopy

Naim Abu-Freha 
1   Gastroenterology Institute, Assuta Medical Center, Beer-Sheva, Israel (Ringgold ID: RIN64850)
2   Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel (Ringgold ID: RIN26732)
3   Institute of Gastroenterology and Hepatology, Soroka Medical Center, Beer Sheva, Israel (Ringgold ID: RIN26746)
,
Avraham Yitzhak
4   Hospital Administration, Beer Sheva, Assuta Medical Center, Tel Aviv, Israel (Ringgold ID: RIN64850)
,
Haim Shirin
5   Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir Medical Center Assaf Harofeh, Tzrifin, Israel (Ringgold ID: RIN37256)
,
Anat Nevo-Shor
3   Institute of Gastroenterology and Hepatology, Soroka Medical Center, Beer Sheva, Israel (Ringgold ID: RIN26746)
,
Jafar Abu-Jaffar
6   Internal Medicine, Kaplan Medical Center, Rehovot, Israel (Ringgold ID: RIN37601)
,
Samer Abu-Rafe
7   Internal Medicine, Soroka Medical Center, Beer Sheva, Israel (Ringgold ID: RIN26746)
,
Yaser Afianish
3   Institute of Gastroenterology and Hepatology, Soroka Medical Center, Beer Sheva, Israel (Ringgold ID: RIN26746)
,
Daniel L. Cohen 
5   Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir Medical Center Assaf Harofeh, Tzrifin, Israel (Ringgold ID: RIN37256)
,
Anton Bermont
5   Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir Medical Center Assaf Harofeh, Tzrifin, Israel (Ringgold ID: RIN37256)
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Colonoscopy preparation adequacy in glucagon-like peptide-1 receptor agonist users: the jury is still outEndoscopy 2025; 57(02): 134-136
DOI: 10.1055/a-2461-3899

Abstract

Background Glucagon-like peptide-1 receptor agonists (GLP-1RAs) affect gastrointestinal motility, slowing gastric emptying and colonic transit. GLP-1RAs have an impact on gastric residue before endoscopy, but only limited data are available regarding its effect on the adequacy of colonic preparation. We investigated the association between GLP-1RA use and inadequate bowel preparation (IBP) for colonoscopy.

Methods We performed a multicenter retrospective study with GLP-1RA cases matched with controls (using propensity scores for age, sex, diabetes mellitus [DM], obesity, and co-morbidities). Data on demographics, medication use, procedural indications, and colonoscopy findings were collected. IBP (“poor preparation” on Aronchik scale or Boston Bowel preparation scale <5) was the primary outcome.

Results 4876 patients treated with GLP-1RAs were included in the analysis and compared with 4876 controls selected from 333 648 patients without GLP-1RA use. Among the GLP-1RA patients, 10% (n = 487) had IBP compared with 197 (4%) of the control group (P<0.001). Subgroup analysis showed a higher rate of IBP among diabetic patients treated with GLP-1RA (284/2364 [12%]) than among diabetic patients without GLP-1RA treatment (118/2364 [5%]; P<0.001). Additionally, 203/2512 nondiabetic patients treated with GLP-1RAs had IBP (8%) compared with 79 of the nondiabetic non-GLP-1RA group (3%; P<0.001). On multivariate analysis, diabetes and GLP-1RA use were both found to be independent risk factors for IBP (odds ratio [OR] 1.4 and OR 2.7, respectively; both P<0.001).

Conclusion Our findings highlight the necessity for special attention and tailored recommendations for both diabetic and nondiabetic patients treated with GLP-1RAs in terms of colonic preparation prior to colonoscopy.

Supplementary Material



Publication History

Received: 23 May 2024

Accepted after revision: 25 July 2024

Article published online:
10 October 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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