GLP-1 agonists might improve danger of abdomen paralysis

According to Mohit Sodhi, researcher and a fourth-year medical scholar on the University of British Columbia and the primary creator of the brand new research, he and his colleagues determined to review the impact of GLP-1 agonists on the gastrointestinal system after noticing a person within the emergency room who had vital unexplained nausea and vomiting.

“Of note, he recently started Ozempic for weight loss,” he defined to Medical News Today. “I had seen a number of anecdotal reports, case reports, and literature describing similar symptoms as this particular patient. Additionally, millions around the world have started using these medications to assist in [their] weight loss goals.”

This isn’t the primary analysis to look at a hyperlink between the usage of GLP-1 agonists and potential gastrointestinal issues.

A research printed in January 2022 linked a number of gastrointestinal issues — together with belly ache, indigestion, belly distension, and gastroesophageal reflux illness — to the usage of GLP-1 agonists.

Research printed in December 2022 additionally reported the usage of GLP-1 receptors was considerably related with gastrointestinal antagonistic results.

Glucagon-like peptide-1 receptor agonists (GLP-1 agonists) are a kind of treatment used to assist handle kind 2 diabetes.

GLP-1 is a hormone naturally discovered within the small gut. These medicines mimic this hormone, triggering the results of the GLP-1 hormone. Because of this mechanism, GLP-1 agonists can:

Types of GLP-1 agonists embody:

Most GLP-1 agonists, reminiscent of Ozempic, Wegovy, and Saxenda, are injected medicines. Rybelsus is available in capsule type.

Currently, solely Wegovy and Saxenda are accepted by the Food and Drug Administration (FDA) as weight reduction medicine.

However, researchers present there’s a rising variety of folks with out diabetes utilizing or concerned about utilizing GLP-1 agonists off-label for weight reduction.

The quantity of weight a person might lose on a GLP-1 agonist varies. Previous analysis exhibits the quantity can fluctuate between 4% and 17%.

How a lot weight is misplaced relies on the person’s well being and what way of life adjustments they make, reminiscent of train and a nutritious diet.

For this research, Sodhi and his staff examined medical insurance declare data for about 16 million folks within the United States to search for prescriptions of both semaglutide or liraglutide between 2006 and 2020.

The research included information from folks with a recent historical past of weight problems and excluded these with diabetes or who’ve been prescribed one other anti-diabetes treatment.

Scientists analyzed the info to see how many individuals developed one in every of 4 gastrointestinal circumstances — pancreatitis, bowel obstruction, gastroparesis, and biliary illness. Those findings had been then in comparison with individuals who took a mixture of bupropion and naltrexone for weight reduction.

Researchers discovered that the members who took GLP-1 agonists had somewhat over 9 instances greater danger of growing pancreatitis, 4.22 instances greater danger of getting a bowel obstruction, and three.67 instances elevated danger for gastroparesis, in comparison with individuals who took bupropion-naltrexone.

“We are not entirely surprised [by these results]. There have been many anecdotal reports and case reports in the literature of these adverse events in patients using these medications for weight loss. However, no epidemiologic study investigated this risk,” Sodhi stated.

“We are strong proponents for informed patient consent. We believe it is crucial for patients to have a full understanding of the potential adverse events associated with any medical therapy that they choose to pursue. We also hope that our study can help inform healthcare providers and make them aware of these risks,” he added.

After reviewing this research, Dr. Rami Bailony, an weight problems specialist and CEO of Enara, who was not concerned within the analysis, informed MNT that his preliminary response was one in every of cautious curiosity as you will need to interpret the leads to a broader context.

“While relative risk percentages might sound alarming, the absolute risk, or the actual number of people affected, can be quite small,” stated Dr. Bailony.

“It’s essential to differentiate between the two to give patients a clear understanding of the real-world implications. While statements like ‘a nine times increased risk’ can sound alarming at first glance, it’s crucial to understand what that actually means in real-world terms,” he defined.

“When the study says there’s a nine times increased risk of pancreatitis, it’s speaking in relative terms. But if we delve into the absolute risk, the actual numbers paint a different picture. For instance, if we look at pancreatitis and its reported incidence rate, it means that for every 1,000 people taking the medication for a year, roughly eight might experience the condition. So, while the relative risk seems high, the absolute number of people affected is relatively small.”
— Dr. Rami Bailony

“This distinction between relative and absolute risk is vital for patients to understand, so they can make informed decisions based on the real-world implications of the data, rather than just the headline numbers,” he stated.

MNT additionally spoke with Dr. Mir Ali, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California, about this research.

He discovered the outcomes unsurprising as a result of one of many mechanisms of the GLP-1 agonists is to gradual gastrointestinal tract emptying, which can additionally have an effect on a person’s capacity to make use of this sort of treatment.

“So it’s not that far a stretch to see how some people may be more sensitive to that. If patients have some indication that they may have poor stomach emptying or other intestinal symptoms, then we may steer them away from GLP-1 agonists and there are other options available,” he stated.

For the following steps in analysis on this sort of analysis, Dr. Bailony stated he want to see extra managed research that account for variables like smoking and gender variations, which may affect the outcomes.

“It would be valuable to have matched cohorts for a more apples-to-apples comparison,” he continued.

“Also, it’s essential to communicate the results in terms of both relative and absolute risks, helping patients and healthcare professionals alike to make informed decisions. As always, the safety and well-being of our patients are paramount, so continuous monitoring and research into these medications are essential,” he stated.

Dr. Ali additionally stated for anybody seeking to drop some weight, regardless of the well being prevention support they struggle — together with medicines, surgical procedure, and counseling — the principle purpose is to assist a person change to a more healthy way of life.

“Nothing works if the patient doesn’t really make an effort to change their behavior. And so the concern is even with medications — they’ll help them lose weight and they may lose weight while they’re on the medications, [but without] long-term changes, when they stop the medication they can regain the weight. So, the goal is to make healthy long-term changes that will help keep the weight off.”
— Dr. Mir Ali