JAMA

GLP-1 agonists associated with higher GI risk than older weight loss drug combo

October 10, 2023

Use of GLP-1 receptor agonists for weight loss compared with use of bupropion-naltrexone is associated with increased risk of pancreatitis, gastroparesis, and bowel obstruction, but not biliary disease.

• The cohort included 4,144 liraglutide, 613 semaglutide, and 654 bupropion-naltrexone users.
• Incidence of biliary disease (per 1,000 person-years) was 11.7 for semaglutide, 18.6 for liraglutide, and 12.6 for bupropion-naltrexone and 4.6, 7.9, and 1.0, respectively, for pancreatitis.
• Compared with buproprion-naltrexone, use of GLP-1 agonists was associated with increased risk of pancreatitis (adjusted HR, 9.09; 95% confidence interval [CI], 1.25-66.00), bowel obstruction (HR, 4.22; 95% CI, 1.02-17.40), and gastroparesis (HR, 3.67; 95% CI, 1.15-11.90), but not biliary disease (HR, 1.50; 95% CI, 0.89-2.53). 
• Study authors noted: “Given the wide use of these drugs, these adverse events, although rare, must be considered by patients who are contemplating using the drugs for weight loss because the risk/benefit calculus for this group might differ from that of those who use them for diabetes.”

Source(s):

Sodhi M, et al. (2023, October 5). JAMA. Risk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss. https://pubmed.ncbi.nlm.nih.gov/37796527/