Quality of bowel preparation for colonoscopy in patients on glucagon-like peptide-1 receptor agonists

Gastrointest Endosc. 2024 Nov 16:S0016-5107(24)03734-9. doi: 10.1016/j.gie.2024.11.024. Online ahead of print.

Abstract

Background and aims: We aimed to assess the quality of bowel preparation in a matched cohort of patients actively using and not using GLP-1 RAs in a large health system in the United States.

Methods: We performed a retrospective review of adult patients undergoing colonoscopy in 22 endoscopy units across 18 sites in the US.

Results: Our cohort comprised 6235 patients (3344 cases and 2891 controls). Baseline variables causing suboptimal bowel preparation were setting of procedure (inpatient), sex (male), BMI (higher), T2D, IBD, opioid medications, heart failure, and cirrhosis. Total BBPS was significantly higher in controls even after controlling for the abovementioned variables (p < 0.01). Cases were significantly more likely to meet the definition of inadequate bowel preparation. There was no significant difference between different classes of GLP-1 RAs.

Conclusions: Patients using GLP-1 RAs are more likely to have inadequate bowel preparation during colonoscopy, even accounting for other comorbidities.

Keywords: Boston Bowel Preparation Score; Bowel Preparation; Colonoscopy; GLP-1 Receptor Agonists.