S973 Esophageal High-Resolution Manometry Can Be Safely and Effectively Performed With Concurrent Glucagon-Like Peptide-1 Receptor Agonist Use

Introduction: Although commonly performed, esophageal high-resolution manometry (HRM) study completion can be limited by patient tolerance. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are associated with delayed gastric emptying which may impair patients’ ability to complete HRM and has been a concern for aspiration in other intraluminal procedures. We aim to assess the safety and feasibility of performing HRM with concurrent GLP-1 RA use. Methods: Patients who underwent successful and unsuccessful HRM procedures at a tertiary care center from January 2014-November 2024 were identified. Patients with established gastrointestinal dysmotility, foregut surgery, mechanical obstruction, and opioid use were excluded. Those patients who were actively on a GLP-1 at the time of attempted procedure were classified as “cases,” and the same number of consecutive patients not on a GLP-1 RA who attempted the procedure were chosen as “controls.” Continuous variables were reported as mean ± standard deviation and categorical variables as percentages. A 2-sample t test was used for comparisons between groups. Results: Among 7,194 patients who attempted HRM, 83 patients on GLP-1 RA during HRM meeting inclusion criteria (cases) were identified. A total of 74 (89.16%) patients on GLP-1 RA successfully completed HRM, and 9 (10.84%) could not complete the procedure. In 83 consecutive controls who met inclusion criteria, 77 (92.8%) successfully completed HRM (P = 0.59). Demographics and indications for procedure were similar between groups except for weight and body mass index, which were expectedly higher in cases compared to controls. In those patients who had unsuccessful procedures, a similar percentage was completed in cases and controls (15.6% ± 11.8 vs 14.2% ± 12.4; P = 0.83), and the HRM was continued for similar length of time before aborting (30.6 ± 7.7 minutes vs 35.8 ± 12.0 minutes; P = 0.37). No patients except 1 in the control group had a history of intolerance to HRM in the past. Two cases and no controls had a history of nasal septal deviation/repair (P = 0.49). A higher frequency of dysphagia was seen among those controls who had unsuccessful procedures, compared to cases; symptomatology and incidence of anxiety and depression were otherwise similar. There were no cases with aspiration or other adverse events. Conclusion: HRM can be safely and effectively completed in patients with GLP-1 RA use. Larger, prospective studies are needed to validate these findings.