*EMBARGOED All research presented at the 2022 ACG Annual Scientific Meeting and Postgraduate Course is strictly embargoed until Sunday, October 23, 2022, at 12:00 pm EDT.
Oral 18 – Predictors of Pancreatitis on Initiation of GLP-1 Receptor Agonists for Weight Loss
Monday, October 24, 2022 | 2:45 PM – 2:55 PM ET | Location: Hall C1
Author Insight from Robert Postlethwaite, MD, University of Texas Southwestern Medical Center
What’s new here and important for clinicians?
This project aimed to identify patient factors that impact the risk of developing acute pancreatitis in patients starting GLP-1 receptor agonists (GLP-1RA) for the goal of weight loss. As this class of medications becomes increasingly popular in the United States, it is important for providers to know which patients are at a higher or lower risk of developing acute pancreatitis after being started on them. In particular, we only included patients being started on a GLP-1RA for the treatment of obesity, not for the treatment of diabetes. In our analysis, we found that a history of type 2 diabetes mellitus, tobacco use, and advanced CKD (CKD stage ≥3) was associated with a higher risk of developing acute pancreatitis. A BMI >36 is associated with a lower risk of developing acute pancreatitis. Notably, known clinical risk factors for acute pancreatitis including alcohol use, prior history of acute pancreatitis, and gallstone disease were not associated with an increased risk of acute pancreatitis after GLP-1RA initiation in this study. In the future, clinicians can utilize this information to risk stratify their patients when prescribing GLP-1RAs. In turn, we can prevent the development of acute pancreatitis in high-risk individuals or at the least be more aware of its risk and be able to identify it early enough to prevent complications. Last, there was no evidence that a prior history of acute pancreatitis increases the risk of developing a subsequent episode after being started on a GLP-1RA. Therefore, clinicians should not withhold these medications for this reason.
What do patients need to know?
Patients can learn a few things from this study. GLP-1 receptor agonists are a class of medications that are classically used to treat diabetes, however they are now also used to treat obesity due to their weight loss effects. If patients have a history of type 2 diabetes mellitus, tobacco use, or advanced chronic kidney disease, then they may be at an increased risk of developing acute pancreatitis, a serious and potentially life-threatening condition, after being started on a GLP-1 receptor agonist for the goal of weight loss. Also, a BMI >36 at the initiation of a GLP-1RA may protect patients against developing acute pancreatitis. Last, if patients have had acute pancreatitis in the past, there is no evidence that patients are at a higher risk of developing a subsequent episode of acute pancreatitis after starting a GLP-1RA. Therefore, this class of medications should not be withheld for this reason, especially given the significant glycemic, cardiovascular, and weight loss effects.
Read the Abstract
Robert Postlethwaite, MD, University of Texas Southwestern Medical Center
Robert.Postlethwaite [at] UTSouthwestern.edu
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