S1307 Examining the Impact of Glucagon-Like Peptide-1 Receptor Agonists on Residual Gastric Contents During Upper Endoscopy: A Systematic Review and Meta-Analysis

Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) delay gastric emptying, affecting glucose metabolism, appetite, and weight management in patients with type 2 diabetes. Individuals using GLP-1 RAs may have increased residual gastric contents, raising the risk of aspiration during endoscopic procedures. Previous studies on this association have shown mixed results. This systematic review and meta-analysis aimed to evaluate the relationship between GLP-1 RA use and residual gastric contents during upper endoscopy. Methods: We searched PubMed, EMBASE, Google Scholar, Web of Science, and the Cochrane Library through May 2024 for studies assessing GLP-1 RA use and gastric residuals during endoscopy. Reference lists of relevant articles were also reviewed. Both fixed-effects and random-effects models were used for the meta-analysis. Results: Of 46 studies screened, 6 cohorts met the inclusion criteria. One was excluded due to incompatible outcome measures and missing data. The final analysis included 5 cohorts with a total of 1,307 participants, of whom 449 (34.4%) were GLP-1 RA users and 858 (65.6%) were non-users. GLP-1 RA users had significantly higher odds of increased gastric residual contents (OR 2.53, 95% CI: 1.63–3.92; P < 0.001). Significant heterogeneity was observed (P < 0.0001). Egger's test indicated no publication bias (P = 0.94). Conclusion: This meta-analysis demonstrates that GLP-1 RAs significantly impact gastric motility and are associated with increased gastric contents in fasting patients undergoing upper endoscopy. However, data on the associated aspiration risk and effects on endoscopic visualization quality remain limited. Further research is warranted to explore these clinical implications.