Evidence map›Paper›PMID 41036293›Full record

SynthesisThe open respiratory medicine journal2025

GLP-1 Agonists and the Risk of Pulmonary Aspiration during Elective Upper Endoscopy: A Systematic Review and Meta-analysis.

Praveen Reddy Elmati, Gowthami Sai Kogilathota Jagirdhar, Rakhtan K Qasba, Andres Perez, Ruman K Qasba, Yatinder Bains, Mehul Shah, Salim Surani

Abstract readSystematic Review
In one paragraph

Synthesis in The open respiratory medicine journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Article
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

8 authors.

Praveen Reddy ElmatiDepartment of Anesthesiology, Saint Clare's Hospital, Dover, NJ 07081, USA.ORCID https://orcid.org/0000-0003-1283-2368
Gowthami Sai Kogilathota JagirdharDepartment of Gastroenterology, Saint Michaels Medical Center, Newark, NJ 07104, USA.ORCID https://orcid.org/0000-0003-1855-0863
Rakhtan K QasbaDepartment of Medicine, Green Life Medical College and Hospital, Dhaka, Bangladesh.ORCID https://orcid.org/0000-0001-5051-9319
Andres PerezDepartment of Medicine, Saint Francis Health Systems, Tulsa, NJ, USA.
Ruman K QasbaDepartment of Medicine, Sher-i-Kashmir institute of medical sciences, Srinagar, Jammu and Kashmir, India.ORCID https://orcid.org/0009-0001-6637-596X
Yatinder BainsDepartment of Gastroenterology, Saint Michaels Medical Center, Newark, NJ 07104, USA.ORCID https://orcid.org/0000-0002-6331-1194
Mehul ShahDepartment of Gastroenterology, Saint Michaels Medical Center, Newark, NJ 07104, USA.ORCID https://orcid.org/0009-0001-3896-7183
Salim SuraniDepartment of Medicine & Pharmacology, Texas A&M University, College Station, TX 77843, Texas, USA.ORCID https://orcid.org/0000-0001-7105-4266

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Glucagon-like Peptide-1 (GLP-1) agonists cause delayed gastric emptying by acting on vagal afferent nerves. Retained gastric contents (RGC) increase the risk of pulmonary aspiration, particularly under anesthesia in endoscopic procedures. This systematic review and meta-analysis aim to summarize the current evidence on pulmonary aspiration in patients receiving GLP-1 agonists undergoing endoscopy. Methods: A systematic review was conducted using Cochrane, Embase, and PubMed from inception to May 2024, including studies and case reports examining GLP-1 agonists and pulmonary aspiration. Data on study characteristics, patient demographics, and GLP-1 agonist use were collected. A pooled analysis of retrospective studies was performed using RevMan version 5.4.1. The study protocol was registered in the PROSPERO database (ID CRD42024595241). Results: A total of five case reports involving six patients and twelve studies including 210,216 patients were identified. Pulmonary aspiration occurred in 143 of 87,691 patients (0.16%) in the GLP-1 agonist group and 149 of 122,525 patients (0.12%) in the placebo group. Notably, three patients experienced aspiration despite stopping GLP-1 agonists more than six days prior and fasting for over eight hours. The meta-analysis showed an odds ratio of 1.23 (P = 0.59; 95% CI, 0.58 to 2.60) for pulmonary aspiration associated with GLP-1 agonist use, which was not statistically significant. Discussion: This analysis did not find a statistically significant association between GLP-1 agonist use and pulmonary aspiration risk during endoscopic procedures. While the findings align with some existing studies suggesting minimal increased risk, the presence of aspiration cases despite prolonged fasting highlights potential gaps in current peri-procedural management. Limitations include reliance on retrospective data and case reports, as well as variability in fasting protocols. Conclusion: The study found no significant association between GLP-1 agonist use and pulmonary aspiration risk during endoscopy. Further research is warranted to develop evidence-based fasting guidelines and optimize peri-procedural management for patients on GLP-1 agonists.

Indexed as

Aspiration complicationElective endoscopyEndoscopyGLP-1 receptor agonistPeriprocedural complicationsPulmonary aspirationSystematic Review

Identifiers

PMID41036293
PMCPMC12481593

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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.