A81 GASTROINTESTINAL ADVERSE EVENTS ASSOCIATED WITH GLUCAGON-LIKE PEPTIDE-1 (GLP-1) AGONISTS IN OVERWEIGHT PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Bibliographic record
Abstract
Abstract Background Glucagon-Like Peptide-1 (GLP-1) agonists are widely prescribed for managing type 2 diabetes and have recently gained attention for their potential in promoting weight loss in obese patients. The off-label use of certain GLP-1 agonists for weight loss has been steadily increasing, raising concerns about their safety in non-diabetic patients. Although the gastrointestinal (GI) side effects of GLP-1 agonists are well-documented in diabetic populations, their impact on overweight or obese individuals has not been systematically analyzed. Aims To systematically review and analyze the incidence, severity, and types of GI adverse events (AEs) associated with the use of GLP-1 agonists in overweight or obese patients (BMI: >25 kg/m2) Methods We conducted a systematic search across five databases, including PubMed, Ovid MEDLINE, Embase, Web of Science, and Scopus. Studies were restricted to randomized controlled trials (RCTs) involving GLP-1 agonists whose primary indication was obesity and whose primary outcome was weight loss. Studies that did not report adverse events were excluded. Adverse events were extracted using their preferred terms from the Medical Dictionary for Regulatory Activities (MedDRA). A meta-analysis was performed to pool the relative risk (RR) of GI AEs using the random effects model. A meta-regression was also performed. Results A total of 42 studies (n = 23318 patients) met the inclusion criteria. GLP-1 agonists showed an increased risk of nausea (RR 2.77; 95% CI 2.50–3.10; p < 0.001), diarrhea (RR 2.01; 95% CI 1.78–2.01; p < 0.001), and constipation (RR 2.13; 95% CI 1.90–2.38; p = 0.05) when compared to placebo. The incidence of nausea was higher in those with lower average BMI (coefficient: 3.88; p = 0.005). Additionally, we found no difference between GLP-1 agonists and placebo in the risk of cholelithiasis, cholecystitis, and biliary dyskinesia (RR 1.62; 95% CI 1.22–2.17; p = 0.99). Conclusions Our study found that obese patients are at an increased risk of experiencing nausea, diarrhea and constipation when using GLP-1 agonists compared to placebo. Gallbladder disorders showed no difference in risk. For obese patients, lower average BMI may increase the likelihood of experiencing nausea. FIgure 1. Forest plot indicating relative risk for nausea in obese patients treated with GLP-1 agonists. Error bars represent 95% confidence intervals. Funding Agencies None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.027 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.019 | 0.036 |
| Bibliometrics | 0.010 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".