Limited evidence exists regarding the impact of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on upper endoscopy. Therefore, a meta-analysis was conducted to comprehensively review the available evidence on this subject. A systematic bibliographic search was carried out until May 2024. Pooled estimates were analyzed using a random-effects model, with results presented as odds ratio (OR) and 95% confidence interval (CI). The primary outcome assessed was the rate of retained gastric content (RGC), while secondary outcomes included rates of aborted and repeated procedures, adverse event rate, and rates of aspiration. This analysis included 13 studies involving a total of 84,065 patients. Patients receiving GLP-1RA therapy exhibited significantly higher rates of RGC (OR, 5.56; 95% CI, 3.35 to 9.23), a trend that was consistent among patients with diabetes (OR, 2.60; 95% CI, 2.23 to 3.02). Adjusted analysis, accounting for variables such as sex, age, body mass index, diabetes, and other therapies, confirmed the elevated rates of RGC in the GLP-1RA user group (adjusted OR, 4.20; 95% CI, 3.42 to 5.15). Furthermore, rates of aborted and repeated procedures were higher in the GLP-1RA user group (OR, 5.13; 95% CI, 3.01 to 8.75; and OR, 2.19; 95% CI, 1.43 to 3.35; respectively). However, no significant differences were found in AE and aspiration rates between the 2 groups (OR, 4.04; 95% CI, 0.63 to 26.03; and OR, 1.75; 95% CI, 0.64 to 4.77; respectively). Use of GLP-1RAs is associated with increased retention of gastric contents and more frequent aborted procedures during upper endoscopy. However, the adverse event and aspiration rates do not seem different; therefore, adjusting fasting time instead of routinely withholding GLP-1RAs could be reasonable in these patients.

中文翻译：

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胰高血糖素样肽 1 受体激动剂对上消化道内镜检查的影响：荟萃分析


关于胰高血糖素样肽 1 受体激动剂 (GLP-1RA) 对上消化道内窥镜检查影响的证据有限。因此，进行了荟萃分析以全面审查有关该主题的现有证据。系统的书目检索一直持续到 2024 年 5 月。使用随机效应模型分析汇总估计值，结果以比值比 (OR) 和 95% 置信区间 (CI) 表示。评估的主要结果是胃内容物滞留率（RGC），次要结果包括中止和重复手术率、不良事件率和误吸率。该分析包括 13 项研究，总共涉及 84,065 名患者。接受 GLP-1RA 治疗的患者表现出显着较高的 RGC 率（OR，5.56；95% CI，3.35 至 9.23），这一趋势与糖尿病患者一致（OR，2.60；95% CI，2.23 至 3.02）。考虑到性别、年龄、体重指数、糖尿病和其他治疗等变量的调整分析证实了 GLP-1RA 用户组中 RGC 发生率升高（调整后 OR，4.20；95% CI，3.42 至 5.15）。此外，GLP-1RA 用户组的中止和重复手术率较高（OR，5.13；95% CI，3.01 至 8.75；OR，2.19；95% CI，1.43 至 3.35；分别）。然而，两组之间的 AE 和误吸率没有显着差异（OR，4.04；95% CI，0.63 至 26.03；OR，1.75；95% CI，0.64 至 4.77）。 GLP-1RA 的使用与上消化道内窥镜检查期间胃内容物滞留的增加和更频繁的中止手术有关。然而，不良事件和误吸发生率似乎并没有什么不同；因此，对于这些患者来说，调整禁食时间而不是常规停用 GLP-1RA 可能是合理的。