GI Adverse Events Increased With Use of GLP-1 Agonists for Weight Loss

FRIDAY, Oct. 6, 2023 (HealthDay News) -- Use of glucagon-like peptide 1 (GLP-1) receptor agonists for weight loss is associated with increased risks for pancreatitis, gastroparesis, and bowel obstruction compared with use of bupropion-naltrexone, according to a research letter published online Oct. 5 in the Journal of the American Medical Association.

Mohit Sodhi, from the University of British Columbia in Vancouver, Canada, and colleagues examined gastrointestinal adverse events associated with GLP-1 agonists used for weight loss in a cohort study involving new users of semaglutide or liraglutide and the active comparator bupropion-naltrexone. Data were included for 4,144 liraglutide, 613 semaglutide, and 654 bupropion-naltrexone users.

The researchers found that the incidence rates for the four outcomes (biliary disease, pancreatitis, bowel obstruction, or gastroparesis) were elevated among GLP-1 agonist users versus bupropion-naltrexone users. For example, the incidence of biliary disease was 11.7, 18.6, and 12.6 per 1,000 person-years for liraglutide, semaglutide, and bupropion-naltrexone, respectively, and the incidence of pancreatitis was 4.6, 7.9, and 1.0, respectively. Significantly increased risks for pancreatitis, bowel obstruction, and gastroparesis were seen for GLP-1 agonists versus bupropion-naltrexone use (hazard ratios [95 percent confidence intervals], 9.09 [1.25 to 66.00], 4.22 [1.02 to 17.40], and 3.67 [1.15 to 11.90], respectively), but not biliary disease (hazard ratio, 1.50; 95 percent confidence interval, 0.89 to 2.53).

"Given the wide use of these drugs, these adverse events, although rare, must be considered by patients who are contemplating using the drugs for weight loss because the risk-benefit calculus for this group might differ from that of those who use them for diabetes," the authors write.

Abstract/Full Text