P5141 - Effect of GLP-1 Receptor Agonists on Quality of Bowel Preparation for Colonoscopy: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis
University of Colorado Anschutz Medical Campus Denver, CO
Hayder Alamily, MD1, Sana Rabeeah, MD2, Omer Najem, MD3, Ban Mashadani, MD4, Bisher Sawaf, MD5, Ibrahim Khalil, MBBS6, Mohamed Omar, MD7, Sandra Chehayeb, MD7, Omar Saab, MD8, Hasan Al-Obaidi, MD9, Mohannad Bitar, MD10, Daly Al-Hadeethi, MD11, Abdulrahman Khaldoon. Hamid, MD12, Sajjad Al-Badri, MBChB13, Lauren Tong, MLIS14, Paula Podrazik, MD4, Samuel Hunter. Dunn, MD4, William J.. Salyers, MD, MPH15, Nathan Tofteland, MD7 1University of Colorado Anschutz Medical Campus, Denver, CO; 2The University of Toledo, Toledo, OH; 3Department of internal medicine, Trinity Health Oakland, Pontiac, MI; 4Baptist Health-University of Arkansas for Medical Sciences, North Little Rock, AR; 5University of Toledo Medical Center, Toledo, OH; 6Dhaka Medical College and Hospital, Dhaka, Dhaka, Bangladesh; 7University of Kansas School of Medicine, Wichita, KS; 8University of Texas Health Science Center, Houston, TX; 9University of Toledo College of Medicine and Life Sciences, Toledo, OH; 10Jamaica Hospital Medical Center, Jamaica, NY; 11Wichita-KUMC, Wichita, KS; 12Jamil Tutanji Hospital, Amman, 'Amman, Jordan; 13College of Medicine, University of Baghdad, Baghdad, Baghdad, Iraq; 14University of Arkansas for Medical Sciences, Little Rock, AR; 15University of Kansas School of Medicine - Wichita, Wichita, KS Introduction: : Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used to manage diabetes and obesity, but their effect on bowel preparation quality for colonoscopy is unclear. Inadequate preparation can reduce polyp detection and necessitate repeat procedures, affecting outcomes. This study evaluates the effect of GLP-1 RAs on bowel prep quality, measured by the Boston Bowel Preparation Score (BBPS), and related colonoscopy outcomes. Methods: A systematic review was performed following PRISMA guidelines, searching PubMed, Embase, and Cochrane databases for studies comparing bowel prep outcomes in GLP-1 RA users versus non-users. Eligible studies were prospective or retrospective cohorts reporting BBPS or related metrics. Statistical analysis was done using R. Risk of bias was assessed via the Newcastle-Ottawa Scale. Meta-regression analyzed the impact of age and sex on BBPS. Random-effects meta-analyses assessed BBPS, BBPS < 5, BBPS < 1 in any segment, inadequate bowel prep, and polyp detection rate. Results: Thirteen studies involving 167,235 patients (64,346 GLP-1 RA users; 102,889 non-users) were included. GLP-1 RA users had significantly lower BBPS (MD -0.36, 95% CI [-0.66, -0.07], p=0.019, I²=71.4%) and higher BBPS < 1 in any segment (MD 9.03%, 95% CI [3.45, 14.61], p=0.02, I²=0%). No significant differences were found in BBPS < 5 (MD 5.40%, 95% CI [-17.16, 27.97], p=0.202, I²=23.1%) or inadequate bowel prep (MD 4.00%, 95% CI [-0.41, 8.41], p=0.068, I²=54.0%). Polyp detection rate was higher among GLP-1 RA users (MD 6.69%, 95% CI [0.01, 13.38], p=0.0499, I²=0%). Despite slightly lower BBPS, the improved detection rate may reflect clinical benefit from reduced motility, less spasm, and better luminal insufflation. Meta-regression showed no significant effect of age (p=0.5509) or sex (p=0.5373) on BBPS. Leave-one-out sensitivity confirmed robustness (MD -0.46 to -0.35, p < 0.05). Discussion: GLP-1 RA use is linked to mildly reduced bowel prep quality and segmental cleaning, likely due to altered gut motility. Yet, increased polyp detection suggests clinical benefit, potentially from reduced spasm and keeping the lumen better insufflated. Future studies should explore optimized prep protocols for GLP-1 RA users.
Figure: GLP1RA Effect on Bowel Preparation Plots
Disclosures: Hayder Alamily indicated no relevant financial relationships. Sana Rabeeah indicated no relevant financial relationships. Omer Najem indicated no relevant financial relationships. Ban Mashadani indicated no relevant financial relationships. Bisher Sawaf indicated no relevant financial relationships. Ibrahim Khalil indicated no relevant financial relationships. Mohamed Omar indicated no relevant financial relationships. Sandra Chehayeb indicated no relevant financial relationships. Omar Saab indicated no relevant financial relationships. Hasan Al-Obaidi indicated no relevant financial relationships. Mohannad Bitar indicated no relevant financial relationships. Daly Al-Hadeethi indicated no relevant financial relationships. Abdulrahman Hamid indicated no relevant financial relationships. Sajjad Al-Badri indicated no relevant financial relationships. Lauren Tong indicated no relevant financial relationships. Paula Podrazik indicated no relevant financial relationships. Samuel Dunn indicated no relevant financial relationships. William Salyers indicated no relevant financial relationships. Nathan Tofteland indicated no relevant financial relationships.
Hayder Alamily, MD1, Sana Rabeeah, MD2, Omer Najem, MD3, Ban Mashadani, MD4, Bisher Sawaf, MD5, Ibrahim Khalil, MBBS6, Mohamed Omar, MD7, Sandra Chehayeb, MD7, Omar Saab, MD8, Hasan Al-Obaidi, MD9, Mohannad Bitar, MD10, Daly Al-Hadeethi, MD11, Abdulrahman Khaldoon. Hamid, MD12, Sajjad Al-Badri, MBChB13, Lauren Tong, MLIS14, Paula Podrazik, MD4, Samuel Hunter. Dunn, MD4, William J.. Salyers, MD, MPH15, Nathan Tofteland, MD7. P5141 - Effect of GLP-1 Receptor Agonists on Quality of Bowel Preparation for Colonoscopy: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
