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Background <p>The efficacy of Glucagon-Like Peptide-1 Receptor Agonists (GLP1RA) for the treatment of obesity has led to considerably increased demand for these medications. GLP1RA use prior to bariatric surgery may represent a novel approach to treating obesity. The objectives of this study were to (1) describe trends in pre-bariatric GLP1RA use, (2) investigate social and clinical factors associated with their use, and (3) evaluate differences in clinical outcomes&#xa0;based on preoperative GLP1RA use.</p> Methods <p>Patients who underwent bariatric surgery at three Indiana hospitals from 2018 to 2023&#xa0;were identified. Patients who utilized GLP1RA in the year preceding surgery were&#xa0;compared to those who did not. Social factors included insurance, income, and&#xa0;unemployment. Outcomes included rates of GLP1RA use, 30-day postoperative&#xa0;readmissions, ED visits, and percent total weight lost (%TWL) at 1 year. Associations&#xa0;between preoperative GLP1RA use and outcomes of interest were evaluated using&#xa0;multivariable logistic and linear regressions.</p> Results <p>Of 2169 patients who underwent surgery, 293 (13.5%) utilized GLP1RA preoperatively.&#xa0;The rate of GLP1RA utilization increased threefold from 2018 to 2023. Males were more&#xa0;likely to receive preoperative GLP1RA (20.1% vs, 12.2%, <i>p</i>&lt;0.001). There were no&#xa0;significant differences in social determinants of health or 30-day postoperative outcomes&#xa0;between patients who did and did not use GLP1RA preoperatively. Similarly, there were&#xa0;no significant differences in %TWL at 1 year postoperatively between groups (median&#xa0;25.5% vs. 27.3%, coefficient, −0.78, 95%CI, −2.26 to 0.70).</p> Conclusions <p>Utilization of GLP1RA in the year prior to bariatric surgery has increased threefold.&#xa0;Preoperative GLP1RA use is not associated with worse 30-day outcomes or differences&#xa0;in %TWL at 1 year postoperatively. Further work is needed to evaluate whether GLP1RA&#xa0;dosing and duration of treatment impact postoperative outcomes.</p>

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Preoperative Glucagon-Like Peptide-1 Receptor Agonist Utilization and Association with Bariatric Surgery Outcomes

  • 期刊论文

  • 发表日期：

    2025年1月14日

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  • Qais AbuHasan,
  • Luke M. Funk,
  • Jane L. Holl,
  • Claire Draucker,
  • Shaun Grannis,
  • Karl Y. Bilimoria,
  • Dimitrios Stefanidis,
  • Tarik K. Yuce

摘要

Background

The efficacy of Glucagon-Like Peptide-1 Receptor Agonists (GLP1RA) for the treatment of obesity has led to considerably increased demand for these medications. GLP1RA use prior to bariatric surgery may represent a novel approach to treating obesity. The objectives of this study were to (1) describe trends in pre-bariatric GLP1RA use, (2) investigate social and clinical factors associated with their use, and (3) evaluate differences in clinical outcomes based on preoperative GLP1RA use.

Methods

Patients who underwent bariatric surgery at three Indiana hospitals from 2018 to 2023 were identified. Patients who utilized GLP1RA in the year preceding surgery were compared to those who did not. Social factors included insurance, income, and unemployment. Outcomes included rates of GLP1RA use, 30-day postoperative readmissions, ED visits, and percent total weight lost (%TWL) at 1 year. Associations between preoperative GLP1RA use and outcomes of interest were evaluated using multivariable logistic and linear regressions.

Results

Of 2169 patients who underwent surgery, 293 (13.5%) utilized GLP1RA preoperatively. The rate of GLP1RA utilization increased threefold from 2018 to 2023. Males were more likely to receive preoperative GLP1RA (20.1% vs, 12.2%, p<0.001). There were no significant differences in social determinants of health or 30-day postoperative outcomes between patients who did and did not use GLP1RA preoperatively. Similarly, there were no significant differences in %TWL at 1 year postoperatively between groups (median 25.5% vs. 27.3%, coefficient, −0.78, 95%CI, −2.26 to 0.70).

Conclusions

Utilization of GLP1RA in the year prior to bariatric surgery has increased threefold. Preoperative GLP1RA use is not associated with worse 30-day outcomes or differences in %TWL at 1 year postoperatively. Further work is needed to evaluate whether GLP1RA dosing and duration of treatment impact postoperative outcomes.