The use of glucagon-like peptide-1 (GLP-1) receptor agonists in weight loss treatments has been associated with an elevated risk of pancreatitis, gastroparesis, and bowel obstruction, according to recent research.
A team of researchers from the University of British Columbia, Canada, conducted a comparative study involving non-diabetic individuals who were using GLP-1 agonists. The study examined 4144 individuals using liraglutide (commonly known as Saxenda) and 613 individuals using semaglutide (marketed as Ozempic/Wegovy). In addition, 654 individuals taking the weight loss drug bupropion-naltrexone were included in the study for comparison.
The results of this study, published as a concise research letter in JAMA, revealed that the use of GLP-1 agonists was associated with an increased risk of pancreatitis (adjusted hazard ratio of 9.09 with a 95% confidence interval of 1.25 to 66.00), bowel obstruction (HR, 4.22 with a 95% CI of 1.02 to 17.40), and gastroparesis (HR, 3.67 with a 95% CI of 1.15 to 11.90). However, there was no statistically significant association with biliary disease (HR, 1.50 with a 95% CI of 0.89 to 2.53) when compared with individuals taking bupropion-naltrexone.
The incidence of biliary disease was found to be higher among liraglutide users (18.6 per 1000 person-years) in comparison to semaglutide users (11.7) and those taking bupropion-naltrexone (12.6). For pancreatitis, the incidence was 7.9 for liraglutide, 4.6 for semaglutide, and 1.0 for bupropion-naltrexone.
The researchers emphasized that while these adverse events are rare, their significance should be taken into consideration by individuals contemplating the use of these drugs for weight loss, especially as the risk-benefit analysis may differ for those using them for diabetes management.
GLP-1 agonists belong to a class of injectable anti-diabetes medications that function by increasing insulin secretion and reducing appetite.
Patients for this study were identified through the PharMetrics Plus database, a comprehensive health claims database in the United States. The study observed these patients from the initiation of their first prescription of the study drug until the first occurrence of biliary disease, pancreatitis, bowel obstruction, or gastroparesis.
One limitation acknowledged by the researchers is that although all GLP-1 agonist users in the study had documented obesity without diabetes, it could not be definitively established whether they were using GLP-1 agonists for weight loss purposes.
In the United Kingdom, both liraglutide and semaglutide have received approval from the National Health Service (NHS) for weight loss treatment. However, semaglutide’s official launch has been delayed due to supply issues. Currently, prescriptions for these drugs are limited to a two-year period, although some experts argue that they should be considered as lifelong treatments for obesity.
Commenting on the findings, Simon Cork, senior lecturer in physiology at Anglia Ruskin University, stressed the importance of patients accessing these drugs only through trusted medical professionals and with ongoing support and monitoring. He emphasized the need for tighter regulation to ensure that these drugs are prescribed only in appropriate circumstances.