Short-Acting GLP-1 RAs Linked With Increased Risk of GERD, Barret’s Esophagus


Patients with diabetes taking a GLP-1 RA of any type had an increased risk of a new GERD diagnosis.

Short-acting glucagon-like peptide 1 (GLP-1) receptor agonists (RA) were associated with an increased development of gastroesophageal reflux disease and Barret’s esophagus in patients with type-2 diabetes, according to recent research.

Investigators conducted a population-based query to examine whether GLP-1 RAs or the type of GLP-1 RA are associated with the development of GERD. Data was collected from TriNetX electronic health record platform, which covers 91 health care organizations from 12 different countries.

The study cohort included patients with an active type-2 diabetes mellitus diagnosis at the time of GLP-1 RA initiation. Because sodium-glucose co-transport 2 inhibitors (SGLT2i) are used in a similar population and are not associated with GERD development, patients using this type of treatment were used as the control group. Patients were matched based on BMI, age, alcohol use disorder, tobacco use disorder, systemic hormone therapy and baseline GERD diagnosis.

Investigators found that compared to those on SGLT2i, diabetic patients on a GLP-1 RA of any type had an increased risk of a new GERD diagnosis, reflux esophagitis, esophageal stricture, Barrett’s esophagus, PPI requirement and having an EGD.

Additionally, the odds ratios for all outcomes were seen to increase when short-acting GLP-1 RAs were compared to SGLT2i. They also were largely attenuated or became non-significant with long-acting GLP-1 RAs. Associations persisted when initial A1c is <7% and mostly persisted when initial BMI was >40, except for esophageal stricture.

“Short-acting but not long-acting GLP-1 RA use is an independent risk factor for developing GERD and Barrett’s esophagus in patients with type 2 diabetic patients,” the investigators concluded.

1. Liu BD, Liang KL, Udemba SC, et al. Short-acting but not long-acting glucagon-like protein-1 receptor agonists are associated with increased development of GERD and Barrett’s esophagus: results from a global healthcare database. Presented at: Digestive Disease Week; May 6-9, 2023; Chicago, IL. Poster 1271.
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