ArticleDigestive diseases and sciences2026
Incidence of Gastrointestinal Adverse Events and Healthcare Resource Utilization in Patients Using Glucagon-Like Peptide-1 Analogs: A Real-World Study.
Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeGlucagon-like peptide-1 receptor agonists (GLP-1) are widely prescribed for diabetes mellitus (DM) and obesity. Growing concerns about gastrointestinal side effects (GI-AE) prompted this real-world study, to assess the incidence of GI-AEs and the associated healthcare burden in patients on GLP-1 s.
methodsUsing the TriNetX® network with 120 million patient records, patients with DM and obesity were grouped into GLP-1 and control cohorts. Propensity score matching (1:1) was performed using demographics, comorbidities, Hemoglobin-A1c, BMI, and other confounders. Incidence, number needed to harm (NNH), and Cox-proportional hazard ratios (HR) were used to compare outcomes at 1 year.
resultsAfter matching, 164,987 patients were included in each cohort. At one year, 31.9% of patients on GLP-1 therapy had GI-AEs (NNH 17.2), with incidence of nausea and vomiting, de-novo gastroesophageal reflux disease (GERD), and de-novo gastroparesis being 13%, 8.7%, and 0.7% respectively. GLP-1 use was associated with an increased risk of nausea and vomiting (HR 1.24 [1.21, 1.26]), GERD (HR 1.18 [1.14, 1.22]), proton pump inhibitor use (HR 1.15 [1.12, 1.19]), esophagitis (HR 1.24 [1.19, 1.30]), gastroparesis (HR 1.57 [1.43, 1.73]), drug-induced pancreatitis (HR 2.85 [1.82, 4.48]) and a decreased risk of bowel obstruction (HR 0.86 [0.80, 0.92]). No significant association was seen with cholecystitis (HR 1.10 [0.97, 1.15]) or choledocholithiasis (HR 1.07 [0.94, 1.21]). Esophagogastroduodenoscopy (EGD) utilization (HR 1.25 [1.20, 1.29]) was higher, but emergency room (ER) visits (HR 0.96 [0.95, 0.98]) and hospital admissions (HR 0.92 [0.91, 0.94]) were lower in the GLP-1 cohort.
conclusionNearly one-third of patients with DM and obesity on GLP-1 therapy reported GI-AEs, primarily nausea/vomiting and GERD. Providers should be aware of these events, given their association with increased EGD utilization but not higher ER visits or hospital admissions.
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