LI Yuzhou,ZOU Shuying,ZHU Xiangnan,et al.Safety of using glucagon-like peptide-1 receptor agonists before gastrointestinal endoscopy: an overview of systematic reviews[J].ZHONGGUO YAOFANG,2026,37(06):806-811.
LI Yuzhou,ZOU Shuying,ZHU Xiangnan,et al.Safety of using glucagon-like peptide-1 receptor agonists before gastrointestinal endoscopy: an overview of systematic reviews[J].ZHONGGUO YAOFANG,2026,37(06):806-811. DOI: 10.6039/j.issn.1001-0408.2026.06.19.
Safety of using glucagon-like peptide-1 receptor agonists before gastrointestinal endoscopy: an overview of systematic reviews
To conduct a systematic review concerning the safety of using glucagon-like peptide-1 receptor agonists (GLP-1RA) before gastrointestinal endoscopy.
METHODS
2
Chinese and English databases including CNKI, Wanfang Data, VIP, CBM, and PubMed were searched to collect systematic reviews and meta-analyses on the safety of using GLP-1RA before gastrointestinal endoscopy, with a search period from the inception to September 30, 2025. Report quality, methodological quality, risk of bias, and evidence quality were assessed using the PRISMA 2020 statement, AMSTAR 2 scale, ROBIS tool, and GRADE tool, respectively. Corrected covered area (CCA) was used to quantitatively evaluate the degree of outcome overlap, and a comprehensive quality analysis was performed on the quantitative results of systematic reviews/meta-analyses.
RESULTS
2
Ten studies were included. All 10 stu
dies had some information deficiencies (15.5-19.5 points), and were at high risk of bias; 9 studies were extremely low methodological quality, while 1 study was low. In terms of evidence quality, among 88 outcome indexes, there was 1 moderate-level index, 28 low-level indexes, and 59 extremely low-level indexes. The CCA values of the incidence of residual gastric contents, aspiration, endoscopy interruption, repeated endoscopy, inadequate bowel preparation and Boston Bowel Preparation Scale scores were 37.30%, 35.00%, 35.00%, 50.00%, 29.60% and 20.00%, respectively. Results of comprehensive quality analysis showed that compared with the control group, the incidence of residual gastric contents, endoscopy interruption and repeated endoscopy were increased significantly in the intervention group, along with a notably prolonged gastric emptying time and a significantly lower score of Boston Bowel Preparation Scale (
P
<0.05). However, the study results regarding the effects of GLP-1RA on the incidence of aspiration and inadequate bowel preparation were inconsistent.
CONCLUSIONS
2
The use of GLP-1RA before gastrointestinal endoscopy can increase certain safety risks, including residual gastric contents, endoscopy interruption and repeated endoscopy, prolong gastric emptying time, and reduce the quality of bowel preparation. However, the effects on aspiration and inadequate bowel preparation remain controversial. The reports included in systematic reviews/meta-analyses exhibited low quality in reporting, methodology and evidence, with high risk of bias. Therefore, conclusions should be interpreted with caution.
USHAKUMARI D S , SLADEN R N . ASA consensus-based guidance on preoperative management of patients on glucagon-like peptide-1 receptor agonists [J ] . Anesthesi-ology , 2024 , 140 ( 2 ): 346 - 348 .
HASHASH J G , THOMPSON C C , WANG A Y . AGA rapid clinical practice update on the management of patients taking GLP-1 receptor agonists prior to endoscopy:communication [J ] . Clin Gastroenterol Hepatol , 2024 , 22 ( 4 ): 705 - 707 .
LI X Y , JIN Y , FENG X Y , et al . Perioperative management of patients on GLP-1 receptor agonists:risks,recom-mendations,and future directions:a narrative review [J ] . J Clin Anesth , 2025 , 104 : 111871 .
TARAR Z I , FAROOQ U , CHAUDHRY A , et al . Evidence report on the safety of gastrointestinal endoscopy in patients on glucagon-like peptide-1 receptor agonists:a systematic review and meta-analysis [J ] . Diagnostics , 2025 , 15 ( 6 ): 770 .
FACCIORUSSO A , RAMAI D , DHAR J , et al . Effects of glucagon-like peptide-1 receptor agonists on upper gastrointestinal endoscopy:a meta-analysis [J ] . Clin Gastroenterol Hepatol , 2025 , 23 ( 5 ): 715 - 725.e3 .
SINGH S , RAHMAN S H , KHAN N , et al . Effects of glucagon-like peptide-1 receptor agonists on endoscopy outcomes:systematic review and meta-analysis [J ] . Gastrointest Endosc , 2025 , 101 ( 2 ): 343 - 349.e5 .
AROMATARIS E , FERNANDEZ R , GODFREY C M , et al . Summarizing systematic reviews:methodological development,conduct and reporting of an umbrella review approach [J ] . Int J Evid Based Healthc , 2015 , 13 ( 3 ): 132 - 140 .
PAGE M J , MOHER D , BOSSUYT P M , et al . PRISMA 2020 explanation and elaboration:updated guidance and exemplars for reporting systematic reviews [J ] . BMJ , 2021 , 372 : n160 .
SHEA B J , REEVES B C , WELLS G , et al . AMSTAR 2:a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions,or both [J ] . BMJ , 2017 , 358 : j4008 .
WHITING P , SAVOVIĆ J , HIGGINS J P T , et al . ROBIS:a new tool to assess risk of bias in systematic reviews was developed [J ] . J Clin Epidemiol , 2016 , 69 : 225 - 234 .
SCHÜNEMANN H J , BRENNAN S , AKL E A , et al . The development methods of official GRADE articles and requirements for claiming the use of GRADE:a statement by the GRADE guidance group [J ] . J Clin Epidemiol , 2023 , 159 : 79 - 84 .
PIEPER D , ANTOINE S L , MATHES T , et al . Systematic review finds overlapping reviews were not mentioned in every other overview [J ] . J Clin Epidemiol , 2014 , 67 ( 4 ): 368 - 375 .
ABDULRAHEEM A , ABUJABER B , AYERS L , et al . Impact of GLP-1 receptor agonists on upper gastrointestinal endoscopy:an updated systematic review and meta-analysis [J ] . Surg Endosc , 2025 , 39 ( 8 ): 5135 - 5151 .
AHMED Z , IQBAL A , ARIF S F , et al . Bowel preparation quality in patients using glucagon-like peptide-1 agonists:a systematic review and meta-analysis [J ] . Gastrointest Endosc , 2026 , 103 ( 2 ): 235 - 240.e5 .
BAIG M U , PIAZZA A , LAHOOTI A , et al . Glucagon-like peptide-1 receptor agonist use and the risk of residual gastric contents and aspiration in patients undergoing GI endoscopy:a systematic review and a meta-analysis [J ] . Gastrointest Endosc , 2025 , 101 ( 4 ): 762 - 771.e13 .
BERAN A , NAYFEH T , AKHRAS A , et al . Effect of glucagon-like peptide-1 receptor agonists on bowel preparation for colonoscopy:a systematic review and meta-analysis [J ] . Am J Gastroenterol , 2025 , 120 ( 7 ): 1653 - 1656 .
CHIU Y T , CHEN Y T , LEE F J , et al . The impact of glucagon-like peptide-1 receptor agonists on the quality indicators of colonoscopy:a systematic review and meta-analysis [J ] . Dig Liver Dis , 2025 , 57 ( 7 ): 1386 - 1392 .
ELMATI P R , JAGIRDHAR G S K , QASBA R K , et al . GLP-1 agonists and the risk of pulmonary aspiration during elective upper endoscopy:a systematic review and meta-analysis [J ] . Open Respir Med J , 2025 , 19 : e187430-64372550 .
TAN Y , ZHANG X , LV X H , et al . Glucagon-like peptide-1 receptor agonists increase the risk of residual gastric content and pulmonary aspiration on upper endoscopy:a meta-analysis [J ] . Dig Liver Dis , 2025 , 57 ( 7 ): 1377 - 1385 .
MILDER D A , MILDER T Y , LIANG S S , et al . Glucagon-like peptide-1 receptor agonists:a narrative review of clinical pharmacology and implications for peri-operative practice [J ] . Anaesthesia , 2024 , 79 ( 7 ): 735 - 747 .
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