2023-10-19 13:13:41
New Study Shows GLP-1 Receptor Agonists for Weight Loss Carry Increased Risks
A recent retrospective registry study has revealed that GLP-1 receptor agonists (RA), such as semaglutide (Wegovy®), which were recently approved for obesity treatment in Germany, effectively help with weight loss but may involve more risks than previously assumed. The study found that the use of GLP-1 RAs was associated with an increased risk of gastroparesis, pancreatitis, intestinal obstruction, and possibly biliary diseases.
The study, published in JAMA, is the first to demonstrate gastrointestinal complications in non-diabetic patients using medication specifically for weight loss. Lead author Dr. Mohit Sodhi from the Faculty of Medicine at the University of British Columbia in Vancouver, Canada, emphasizes that these complications, although rare, must be considered when patients are considering the use of GLP-1 RAs for weight loss due to their widespread use.
The researchers analyzed health insurance data from 16 million U.S. patients between 2006 and 2020 to identify those who were prescribed semaglutide or liraglutide for weight loss. Only patients who were obese and not diagnosed with diabetes were included in the study to ensure that the GLP-1 RAs were being used specifically for weight loss. This approach was necessary because there was no approval for these drugs for obesity therapy during the study period.
Among the cohort, the study found that the incidence rates of pancreatitis, intestinal obstruction, gastroparesis, and gallbladder and bile duct diseases were higher under GLP-1 RAs compared to the comparator drug, bupropion-naltrexone.
The adjusted hazard ratios revealed that the use of GLP-1 RAs was associated with a 9.09-fold higher risk of pancreatitis, a 4.22-fold higher risk of intestinal obstruction (for liraglutide only), and a 3.67-fold higher risk of gastroparesis.
However, it is important to note that the study did not take into account the patients’ weight progression, and thus the gallbladder events may need to be corrected for weight loss. Nevertheless, the study emphasizes the need for caution when prescribing GLP-1 RAs, ensuring that the potential benefits outweigh the risks.
A meta-analysis of 76 randomized controlled trials published in 2022 also found a significant increase in the risk of gallbladder and bile duct diseases with GLP-1 RAs, particularly when used in higher doses, over a longer period of time, and for the purpose of weight loss.
In light of these findings, both Dr. Sodhi and Professor Dr. Jens Aberle, head of the endocrinology and diabetology department as well as the obesity center at the University Hospital Hamburg-Eppendorf, stress the importance of informing patients about these risks. They urge patients to seek immediate medical help if any complications arise and underscore the need for cautious prescription practices that prioritize patients who stand to benefit the most from weight loss due to weight-related comorbidities.
While GLP-1 RAs have shown promise in aiding weight loss, it is crucial to balance the potential benefits with the increased risks associated with their use. As further research is conducted, it is essential to prioritize patient safety and only prescribe these medications to patients who will most likely experience a strong medical benefit in relation to weight-related health conditions.]
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