American College of Gastroenterology, Oct. 24-29

The annual meeting of the American College of Gastroenterology was held from Oct. 24 to 29 in Phoenix, attracting participants from around the world, including gastroenterology and digestive disease specialists and other health care professionals. The conference featured presentations focusing on clinical updates in gastroenterology and hepatology as well as the latest advances in digestive health and gastrointestinal disorders.

In one study, Basil Jalamneh, M.D., of the Cleveland Clinic Foundation, and colleagues performed a large real-world retrospective cohort study with propensity score matching that compared the cardiovascular outcomes and safety profiles of tirzepatide versus semaglutide in patients with metabolic-associated steatotic liver disease (MASLD)/metabolic-associated steatohepatitis (MASH).

The authors aimed to determine if the dual mechanism of a glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 (GLP-1) receptor agonist (tirzepatide) would offer more cardio-protection than a selective GLP-1 receptor agonist alone (semaglutide). The safety outcomes and side effects of the two medications were also compared.

The researchers found that tirzepatide was significantly associated with decreased mortality, hospitalization, myocardial infarction, peripheral vascular disease, and heart failure events. The safety outcomes of pancreatitis, cholecystitis, choledocholithiasis, hypoglycemia, and gastroparesis were similar between the two groups. Tirzepatide was significantly associated with fewer acute kidney injury events.

“Both tirzepatide and semaglutide offer unprecedented benefit in MASLD/MASH patients; however, tirzepatide is associated with decreased burden of cardiovascular complications compared to semaglutide,” Jalamneh said. “Therefore, patients with coronary heart disease, heart failure, or frequent hospitalization would see the most clinically meaningful benefit from tirzepatide.”

One author disclosed financial ties to Ipsen.

Abstract No. Oral 31

In another study, Jessica L. Halabi, M.D., of Johns Hopkins Hospital in Baltimore, and colleagues found that delaying cholecystectomy is associated with a much higher risk for recurrent biliary complications compared with same-admission surgery among patients with choledocholithiasis.

The authors followed more than 500 patients admitted with choledocholithiasis across a large health system and compared outcomes between those who underwent early cholecystectomy (during the index admission) and those whose surgery was delayed or not done.

Biliary complications, readmissions, and mortality over one year were investigated. The researchers also evaluated whether or not endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy or temporary biliary stenting reduced the risk for recurrent biliary events in patients awaiting surgery.