Impact of Discontinuing GLP-1 Receptor Agonists for Two Weeks Prior to Upper Endoscopy on the Risk of Gastric Retention

Fudan University

Status: Not yet enrolling

Conditions: Gastric Retention

Treatments: Other: No Intervention: Observational Cohort

Study type: Observational

Funder types: Other

Identifiers

NCT07276763

2025K368

Details and patient eligibility

About

A retrospective observational study to explore the impact of discontinuing GLP-1 receptor agonists for two weeks prior to upper endoscopy on the risk of gastric retention

Full description

Glucagon-like peptide-1 receptor agonists (GLP-1RAs), including semaglutide, liraglutide, and dulaglutide, are widely used for the management of type 2 diabetes and obesity. These agents improve glycemic control in part by delaying gastric emptying, but this pharmacologic effect may increase the risk of retained gastric contents (RGC) and aspiration during anesthesia or sedation. In 2023, the American Society of Anesthesiologists (ASA) and the American Society for Gastrointestinal Endoscopy (ASGE) issued recommendations to withhold GLP-1RAs before procedures; however, the optimal discontinuation interval remains uncertain.

Using the electronic medical record system of Huadong Hospital, this retrospective study analyzed patients who underwent upper endoscopy between August 2023 and May 2025 to examine the association between different GLP-1RA exposure patterns and the risk of RGC, providing evidence to inform optimization of pre-procedural discontinuation strategies.

Enrollment: 16,509 estimated patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Undergoing elective upper endoscopy
• Complete clinical information available, including endoscopy report, age, sex, BMI, history of diabetes, prior gastric surgery, and gastrointestinal symptom

Exclusion criteria

• Presence of upper gastrointestinal malignancy or obstruction
• History of gastric surgery (including ESD, gastrectomy, gastric bypass, etc.)
• Emergency endoscopy or non-elective procedures
• Missing key clinical information

Trial design

16,509 participants in 3 patient groups

No GLP-1RA group

Description:

Patients with no prescription record of GLP-1RAs, or whose most recent prescription was more than 3 months before the EGD

Treatment:

Other: No Intervention: Observational Cohort

GLP-1RA Continued group

Description:

Patients who met both of the following criteria: 1. Continued use of a GLP-1RA (e.g., semaglutide or dulaglutide) within 3 months prior to EGD; 2. Underwent painless EGD before August 2024, when our institution had not yet implemented restrictions on GLP-1RA use for painless endoscopy.

Treatment:

Other: No Intervention: Observational Cohort

GLP-1RA Held 2 Weeks group

Description:

Patients who met both of the following criteria: 1. Continued use of a GLP-1RA (e.g., semaglutide or dulaglutide) within 3 months prior to EGD; 2. Underwent painless EGD after August 2024, when institutional policy mandated that patients discontinue GLP-1RAs for at least 14 days prior to painless EGD.

Treatment:

Other: No Intervention: Observational Cohort