305 Are Obese Individuals More Responsive to the Gastric Effects of GLP-1 Receptor Agonists? a Meta-Analytic Perspective

Abstract Aim This is a systematic review and meta-analysis that aims to assess the effect of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on gastric emptying, especially studying their action on the obese population subgroup. Method We searched the major databases, including Medline, Embase, Scopus and Web of Science, using the appropriate MESH terms. Gastric emptying outcomes such as half-time (t1/2), time to maximum plasma concentration (t-max), peak concentration (C-max), and area under the curve (AUC) were examined. A random-effects model was applied, and subgroup analyses were conducted focusing on obese populations. Results Twelve clinical studies were included. GLP-1 RAs significantly delayed gastric emptying, as evidenced by prolonged t1/2 and t-max and decreased C-max and AUC values compared to placebo. Subgroup analysis involving obese patients included four studies that measured the gastric emptying of solids using scintigraphy. The results showed a significantly prolonged t1/2 in the GLP-1 RA group compared to placebo. Sensitivity analysis indicated that removing one study reduced heterogeneity from 55% to 0%, confirming the validity of this finding. Conclusions GLP-1 RAs significantly delay gastric emptying, contributing to appetite suppression and weight reduction. This effect is more consistent in obese populations. While that indicates better metabolic control in obese patients, gastrointestinal side effects may also vary among different patient groups. Therefore, tailored prescriptions to different patient groups are warranted to ensure the best metabolic control and the least side effects.