GLP-1 agonists linked to higher risk of rare but serious GI complications

People taking semaglutide or liraglutide for weight management are at a higher risk of rare but potentially serious gastrointestinal issues, compared with those taking naltrexone/bupropion, according to a large epidemiologic study.

People taking either of these glucagon-like peptide-1 (GLP-1) receptor agonists had a nine times elevated risk of pancreatitis. They were also four times more likely to develop bowel obstruction and over 3.5 times more likely to experience gastroparesis.

The study included 4,144 people taking liraglutide, 613 taking semaglutide, and 654 taking naltrexone/bupropion. They included patients with a recent history of obesity but excluded those with diabetes or who had been prescribed another diabetes medication. The use of GLP-1 agonists compared with naltrexone/bupropion was found to be associated with an increased risk for pancreatitis, bowel obstruction and gastroparesis.

Simon Cork, senior lecturer in physiology, Anglia Ruskin University in Cambridge, England, noted: “It’s important to look at this in the proper context. Obesity significantly increases the risk for developing cardiovascular disease, Type 2 diabetes, cancer, gallbladder disease, and stroke ­– risks that fall dramatically with clinically meaningful and sustained weight loss. For the overwhelming majority of patients for whom these drugs are targeted (those with the most severe forms of obesity), the benefits of weight loss far outweigh the risks.”

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