Patients Can Take GLP-1 RA Medications Before Surgery

Meta-analysis reveals gastric emptying delay of ∼36 minutes

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 T1/2 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 Tmax, area under the curve (AUC)4hour, and AUC5hour 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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