PDF(Pubmed)
Abstract：
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are commonly used diabetes and obesity medications but have been associated with gastrointestinal (GI) adverse events. However, real-world evidence on comparative GI adverse reaction profiles is limited.
OBJECTIVE: This study aimed to evaluate GI adverse events among GLP-1 RA users and compare semaglutide, dulaglutide, liraglutide, and exenatide safety regarding the GI adverse reaction profile.
METHODS: This retrospective cross-sectional analysis utilized real-world data on 10,328 adults with diabetes/obesity in the National Institutes of Health All of Us cohort. New GLP-1 RA users were identified, and GI adverse events were examined. Logistic regression determined factors associated with GI adverse events.
RESULTS: The mean age of the study population was 61.4 ± 12.6 years, 65.7% were female, 51.3% were White, and they had a high comorbidity burden. Abdominal pain (57.6%) was the most common GI adverse event, followed by constipation (30.4%), diarrhea (32.7%), nausea and vomiting (23.4%), GI bleeding (15.9%), gastroparesis (5.1%), and pancreatitis (3.4%). Dulaglutide and liraglutide had higher rates of abdominal pain, constipation, diarrhea, and nausea and vomiting than semaglutide and exenatide. Liraglutide and exenatide had the highest pancreatitis (4.0% and 3.8%, respectively). Compared to semaglutide, dulaglutide and liraglutide had higher odds of abdominal pain, and nausea and vomiting. They also had higher odds of gastroparesis than semaglutide. No significant differences existed in GI bleeding or pancreatitis risks between the GLP-1 RAs.
CONCLUSIONS: In this real-world cohort, GI adverse events were common with GLP-1 RAs. Differences in GI safety profiles existed between agents, with exenatide appearing safer than other GLP-1 RAs, except for gastroparesis. These findings can inform GLP-1 RA selection considering GI risk factors. Further studies are needed to evaluate the causal relationship and GLP-1 RA safety with concomitant medication use.
OBJECTIVE: This study aimed to evaluate GI adverse events among GLP-1 RA users and compare semaglutide, dulaglutide, liraglutide, and exenatide safety regarding the GI adverse reaction profile.
METHODS: This retrospective cross-sectional analysis utilized real-world data on 10,328 adults with diabetes/obesity in the National Institutes of Health All of Us cohort. New GLP-1 RA users were identified, and GI adverse events were examined. Logistic regression determined factors associated with GI adverse events.
RESULTS: The mean age of the study population was 61.4 ± 12.6 years, 65.7% were female, 51.3% were White, and they had a high comorbidity burden. Abdominal pain (57.6%) was the most common GI adverse event, followed by constipation (30.4%), diarrhea (32.7%), nausea and vomiting (23.4%), GI bleeding (15.9%), gastroparesis (5.1%), and pancreatitis (3.4%). Dulaglutide and liraglutide had higher rates of abdominal pain, constipation, diarrhea, and nausea and vomiting than semaglutide and exenatide. Liraglutide and exenatide had the highest pancreatitis (4.0% and 3.8%, respectively). Compared to semaglutide, dulaglutide and liraglutide had higher odds of abdominal pain, and nausea and vomiting. They also had higher odds of gastroparesis than semaglutide. No significant differences existed in GI bleeding or pancreatitis risks between the GLP-1 RAs.
CONCLUSIONS: In this real-world cohort, GI adverse events were common with GLP-1 RAs. Differences in GI safety profiles existed between agents, with exenatide appearing safer than other GLP-1 RAs, except for gastroparesis. These findings can inform GLP-1 RA selection considering GI risk factors. Further studies are needed to evaluate the causal relationship and GLP-1 RA safety with concomitant medication use.
摘要：
背景：胰高血糖素样肽-1受体激动剂（GLP-1RA）是常用的糖尿病和肥胖药物，但与胃肠道（GI）不良事件有关。然而,关于比较GI不良反应概况的真实世界证据有限。
目的：本研究旨在评估GLP-1类风湿性关节炎使用者的胃肠道不良事件，杜拉鲁肽,利拉鲁肽,和艾塞那肽关于胃肠道不良反应的安全性。
方法：这项回顾性横断面分析利用了美国国立卫生研究院（NationalInstitutesofHealthAllofUs）中10,328名患有糖尿病/肥胖症的成年人的真实数据。确定了新的GLP-1RA用户，并检查胃肠道不良事件。Logistic回归确定与GI不良事件相关的因素。
结果：研究人群的平均年龄为61.4±12.6岁，65.7%是女性，51.3%是白人，他们有很高的共病负担。腹痛（57.6%）是最常见的胃肠道不良事件，其次是便秘(30.4%)，腹泻（32.7%），恶心和呕吐（23.4％），消化道出血（15.9%），胃轻瘫(5.1%),和胰腺炎（3.4%）。杜拉鲁肽和利拉鲁肽的腹痛发生率较高，便秘,腹泻,恶心和呕吐比司马鲁肽和艾塞那肽。利拉鲁肽和艾塞那肽的胰腺炎发生率最高（4.0%和3.8%，分别)。与司马鲁肽相比，杜拉鲁肽和利拉鲁肽的腹痛几率更高，恶心和呕吐。他们的胃轻瘫几率也高于司马鲁肽。GLP-1RA之间的胃肠道出血或胰腺炎风险没有显着差异。
结论：在这个现实世界中，GI不良事件在GLP-1RA中很常见。不同药物之间的胃肠道安全特征存在差异，艾塞那肽似乎比其他GLP-1RA更安全，除了胃轻瘫.这些发现可以告知GLP-1RA选择考虑GI风险因素。需要进一步的研究来评估伴随用药的因果关系和GLP-1RA安全性。
目的：本研究旨在评估GLP-1类风湿性关节炎使用者的胃肠道不良事件，杜拉鲁肽,利拉鲁肽,和艾塞那肽关于胃肠道不良反应的安全性。
方法：这项回顾性横断面分析利用了美国国立卫生研究院（NationalInstitutesofHealthAllofUs）中10,328名患有糖尿病/肥胖症的成年人的真实数据。确定了新的GLP-1RA用户，并检查胃肠道不良事件。Logistic回归确定与GI不良事件相关的因素。
结果：研究人群的平均年龄为61.4±12.6岁，65.7%是女性，51.3%是白人，他们有很高的共病负担。腹痛（57.6%）是最常见的胃肠道不良事件，其次是便秘(30.4%)，腹泻（32.7%），恶心和呕吐（23.4％），消化道出血（15.9%），胃轻瘫(5.1%),和胰腺炎（3.4%）。杜拉鲁肽和利拉鲁肽的腹痛发生率较高，便秘,腹泻,恶心和呕吐比司马鲁肽和艾塞那肽。利拉鲁肽和艾塞那肽的胰腺炎发生率最高（4.0%和3.8%，分别)。与司马鲁肽相比，杜拉鲁肽和利拉鲁肽的腹痛几率更高，恶心和呕吐。他们的胃轻瘫几率也高于司马鲁肽。GLP-1RA之间的胃肠道出血或胰腺炎风险没有显着差异。
结论：在这个现实世界中，GI不良事件在GLP-1RA中很常见。不同药物之间的胃肠道安全特征存在差异，艾塞那肽似乎比其他GLP-1RA更安全，除了胃轻瘫.这些发现可以告知GLP-1RA选择考虑GI风险因素。需要进一步的研究来评估伴随用药的因果关系和GLP-1RA安全性。
