S420 Effects of Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RA) on Colonoscopy: A Systematic Review and Meta-Analysis

Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1) are a class of medications that act by slowing gastric emptying, suppressing appetite, and stimulating insulin secretion. These medications are widely used in diabetics and management of obesity. The impact of this class of medications on the quality of colonoscopy preparation still remains unclear. Methods: A systematic review of literature using databases such as Embase, PubMed, Google Scholar, Ovid, and Cochrane was screened for articles from October, 2024-November, 2024 using keywords of colonoscopy preparation and GLP-1 RA. Primary outcomes of interest were Boston Bowel Preparation Scale (BBPS) scores and adequacy of bowel preparation mainly defined in literature as a BBPS score of ≥6. Statistical analysis was completed with R using both a common effect model and a random effect model. Results: A total of 11 studies which included 1,388 individuals on GLP-1 RA and 49,439 controls was analyzed. There was no significant difference in the odds ratio of individuals on a GLP-1 RA vs individuals not on a GLP-1 RA in the overall adequacy of bowel preparation [odds ratio 0.85, 95% confidence interval [0.73-1.09]]. It is to be noted that although no significant difference is demonstrated in the adequacy versus inadequacy of the bowel preparation the standardized mean difference for 10 studies which reported the mean BBPS did demonstrate on average to have a lower BBPS value compared to the control arm [-0.50, 95% confidence interval [-0.80-(-0.20)]]. Conclusion: GLP-1 RA do not affect the adequacy of bowel preparation however, are noted to have on average a lower BBPS score compared to those not on GLP-1 RA.