Evidence map›Paper›PMID 39438043›Full record

ArticleBMJ (Clinical research ed.)2024

Glucagon-like peptide-1 receptor agonists before upper gastrointestinal endoscopy and risk of pulmonary aspiration or discontinuation of procedure: cohort study.

Wajd Alkabbani, Karine Suissa, Kristine D Gu, Sara J Cromer, Julie M Paik, Katsiaryna Bykov, Ion Hobai, Christopher C Thompson, Deborah J Wexler, Elisabetta Patorno

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PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Wajd AlkabbaniDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.ORCID 0000-0002-7030-0442
Karine SuissaDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Kristine D GuDiabetes Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Sara J CromerDiabetes Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Julie M PaikDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Katsiaryna BykovDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Ion HobaiDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
Christopher C ThompsonDivision of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Deborah J WexlerDiabetes Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Elisabetta PatornoDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA epatorno@bwh.harvard.edu.ORCID 0000-0002-8809-9898

Funding

Novel approaches to improve comparative effectiveness research of medical and surgical weight reduction strategies in clinical practiceR01DK138036 · NIDDK · BRIGHAM AND WOMEN'S HOSPITAL · PI Elisabetta Patorno · 2024 to 2026
$2.3M
Optimizing the Safety of the Newer Diabetes Medications in Patients with Diabetes and Kidney DiseaseR01DK135706 · NIDDK · BRIGHAM AND WOMEN'S HOSPITAL · PI Julie M Paik · 2024 to 2026
$2.2M
Novel approaches to identify and quantify the impact of drug-drug interactions in older adults with diabetes, with a focus on multimorbidity and polypharmacyK01AG068365 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI BYKOV, KATSIARYNA · 2021 to 2025
$621k
NIA NIH HHS K01 AG068365NIDDK NIH HHS R01 DK135706NIDDK NIH HHS R01 DK138036
6 · The paper itself

Abstract

objectiveTo assess whether use of glucagon-like peptide-1 (GLP-1) receptor agonists before upper gastrointestinal endoscopy is associated with increased risk of pulmonary aspiration or discontinuation of the procedure compared with sodium-glucose cotransporter-2 (SGLT-2) inhibitors.

designCohort study.

settingTwo deidentified US commercial healthcare databases.

participants43 365 adults (≥18 years) with type 2 diabetes who used a GLP-1 receptor agonist or SGLT-2 inhibitor within 30 days before upper gastrointestinal endoscopy.

main outcome measuresThe primary outcome was pulmonary aspiration on the day of or the day after endoscopy, defined using diagnostic codes. The secondary outcome was discontinuation of endoscopy. Risk ratios and corresponding 95% confidence intervals (CIs) were estimated after fine stratification weighting based on propensity score.

resultsAfter weighting, 24 817 adults used a GLP-1 receptor agonist (mean age 59.9 years; 63.6% female) and 18 537 used an SGLT-2 inhibitor (59.8 years; 63.7% female). Among users of GLP-1 receptor agonists and SGLT-2 inhibitors, the weighted risk per 1000 people was, respectively, 4.15 and 4.26 for pulmonary aspiration and 9.79 and 4.91 for discontinuation of endoscopy. Compared with SGLT-2 inhibitor use, GLP-1 receptor agonist use was not associated with an increased risk of pulmonary aspiration (pooled risk ratio 0.98, 95% CI 0.73 to 1.31), although it was associated with a higher risk for discontinuation of endoscopy (1.99, 1.56 to 2.53).

conclusionsIn this comparative cohort study, no increased risk of pulmonary aspiration during upper gastrointestinal endoscopy was observed among adults with type 2 diabetes using GLP-1 receptor agonists compared with SGLT-2 inhibitors within 30 days of the procedure; however, GLP-1 receptor agonists were associated with a higher risk of discontinuation of endoscopy, possibly owing to a higher risk of retained gastric content. In the absence of evidence from randomized trials, these findings could inform future practice recommendations on the preprocedural protocol for patients requiring endoscopy.

Indexed as

Diabetes Mellitus, Type 2Endoscopy, GastrointestinalGlucagon-Like Peptide-1 Receptor AgonistsRespiratory AspirationAdultAgedCohort StudiesFemaleHumansHypoglycemic AgentsMaleMiddle AgedRisk FactorsSodium-Glucose Transporter 2 InhibitorsGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 Inhibitors

Identifiers

PMID39438043
PMCPMC11494456

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.