Patients Can Take GLP-1 RA Medications Before Surgery

WEDNESDAY, June 12, 2024 (HealthDay News) — Glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications do slow gastric emptying but not by enough to warrant discontinuing medications before surgery, according to a review published in the June issue of the American Journal of Gastroenterology.

Brent Hiramoto, M.D., from Brigham and Women”s Hospital in Boston, and colleagues conducted a systematic review and meta-analysis to provide quantitative measures of gastric emptying relevant to mechanisms of weight loss and to periprocedural management of GLP-1 RAs.

For the five studies (247 patients) that utilized gastric emptying scintigraphy, the researchers found that mean T_1/2 was 138.4 minutes for GLP-1 RAs versus 95.0 minutes for placebo, with a pooled mean difference of 36.0 minutes (I² = 79.4 percent). For the 10 studies (411 patients) that used the acetaminophen absorption test, there was no significant delay in gastric emptying measured by T_max, area under the curve (AUC)_4hour, and AUC_5hour with GLP-1 RAs. There was no impact on gastric emptying for the type of GLP-1 RA, mechanism of action, or treatment duration.

“Based on our study, we recommend that guidelines be updated with the following precautions for GLP-1 RA users undergoing endoscopic procedures: continue therapy, follow a liquid-only diet the day prior, and adhere to standard pre-anesthesia fasting,” Hiramoto said in a statement. “Until more data on solid diets is available, a conservative approach with a liquid diet while continuing therapy is advisable.”

One author disclosed ties to the pharmaceutical industry.

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