A recent study from the University of British Columbia found that GLP-1 agonists, a type of diabetes drug used off-label for weight loss, increase the risk of serious gastrointestinal complications. The study looked at non-diabetic patients using these drugs for weight loss and found an increased risk of pancreatitis, intestinal obstruction, and gastroparesis. Although this situation is rare, given the huge number of users around the world, many users may still be affected. Researchers are advocating for clearer warning labels to ensure patients are adequately informed.
Although these are hailed as an effective way to lose weight, diabetes drugs like Ozempic can carry an increased risk of severe gastrointestinal problems.
That’s according to a new study from the University of British Columbia that drugs known as GLP-1 agonists (which include brands such as Wegovy, Ozempic, Rybelsus, and Saxenda) are linked to gastroparesis, pancreatitis, and intestinal obstruction.
Findings in non-diabetic patients
Previous studies have highlighted some of these risks in patients with diabetes, but this is the first large population-level study to examine gastrointestinal adverse events in non-diabetic patients specifically using drugs for weight loss. It’s research. The survey results are announced today. Japan Automobile Manufacturers Association.
“Given the widespread use of these drugs, these adverse events, although rare, should be considered by patients considering their use for weight loss purposes,” said lead author and graduate of the UBC Experimental Medicine Program. said Mohit Sodhi, a fourth-year UBC medical student. Study of adverse events of commonly prescribed drugs. “The risk calculation differs depending on whether the patient is using these drugs for diabetes, obesity, or simply for weight loss. An otherwise healthy person would not experience these potentially serious adverse events. They may not want to accept it.”
Increase in off-label use
The lead author is Mohit Sodhi of the University of British Columbia.Credit: UBC Faculty of Medicine
GLP-1 agonists were originally developed for the management of type 2 diabetes, but have exploded in popularity over the past decade as an off-label weight loss tool, with approximately 40 million prescriptions expected in the U.S. by 2022. The item has been reached.
It wasn’t until 2021 that some drugs were approved to treat obesity. However, randomized clinical trials examining the effectiveness of pharmacotherapy for weight loss were not designed to capture rare gastrointestinal events due to small sample sizes and short follow-up periods.
“There are anecdotal reports of some patients using these drugs for weight loss and subsequently developing repeated episodes of nausea and vomiting secondary to a condition called gastroparesis,” said lead author and author of Epidemiology said Dr. Mahyal Etminan, an associate professor at the same university. Department of Ophthalmology and Visual Sciences, UBC Faculty of Medicine. “But so far, there is no data from large-scale epidemiological studies.”
Detailed research results
To fill this knowledge gap, UBC researchers examined the health insurance claims records of approximately 16 million U.S. patients and examined the effects of semaglutide, two major GLP-1 agonists, between 2006 and 2020. They looked at people who were prescribed either liraglutide or liraglutide. Those who were obese, had diabetes, or were prescribed another antidiabetic drug were excluded.
The researchers analyzed the records to see how many patients developed one of four gastrointestinal conditions and compared the rates with those who used another weight-loss drug, bupropional naltrexone. Compared to bupropion-naltrexone, GLP-1 agonists were associated with:
- 9.09 times higher risk of pancreatitis or inflammation of the pancreas. Pancreatitis can cause severe abdominal pain and may require hospitalization and surgery.
- 4.22 times higher risk of intestinal obstruction. An intestinal obstruction is a condition in which food cannot pass through the small or large intestine, causing symptoms such as cramping, bloating, nausea, and vomiting. Depending on the severity, surgery may be required.
- 3.67 times higher risk of gastroparesis or gastroparesis. Gastroparesis restricts the passage of food from the stomach to the small intestine, causing symptoms such as vomiting, nausea, and abdominal pain.
The study also found a higher incidence of biliary tract disease, a group of diseases that affect the gallbladder, but the difference was not found to be statistically significant.
Meaning and recommendations
Researchers say this is rare, but hundreds of thousands of people could still experience these symptoms, as millions of people around the world use the drug.
“These drugs are becoming more and more available, and it’s important to note that people may be able to simply order these types of drugs online, even though we don’t fully understand what could potentially happen. “This is concerning. This goes directly against the idea of informed consent,” Sodhi said.
In the meantime, researchers hope that regulators and drug manufacturers will consider updating warning labels on their products, which do not currently include the risk of gastroparesis.
“This is important information that patients need to know so they can seek timely medical attention and avoid serious consequences,” Sodhi said.
Reference: “Risk of Gastrointestinal Adverse Events Associated with Glucagon-like Peptide 1 Receptor Agonists for Weight Loss” by Mohit Sodhi, Ramin Rezaeianzadeh, Abbas Kezouh, Mahyar Etminan, October 5, 2023. Japan Automobile Manufacturers Association.
DOI: 10.1001/jama.2023.19574
