Low Incidence of Pulmonary Aspiration During Upper Endoscopy in Patients Prescribed a Glucagon-Like Peptide 1 Receptor Agonist
Abstract
Glucagon-like peptide 1 (GLP-1) receptor agonists have transformed the treatment of type 2 diabetes and obesity. These agents have been associated with varying degrees of delay in gastric emptying, and a significant proportion of patients experience digestive side effects.1 There have been previous case reports of gastric retention of food and pulmonary aspiration during upper gastrointestinal (GI) endoscopy in the setting of GLP-1 receptor agonist use 2; however, the cumulative incidence has not been previously explored.
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In a Mayo Clinic analysis of 4134 GLP-1 RA users undergoing upper endoscopy, only two confirmed aspiration events were identified (4.8 events per 10,000 procedures), closely mirroring a historical rate of 4.6 per 10,000.
“In a Mayo Clinic analysis of 4134 GLP-1 RA users undergoing upper endoscopy, only two confirmed aspiration events were identified (4.8 events per 10,000 procedures), closely mirroring a historical rate of 4.6 per 10,000 prior to widespread GLP-1 RA use.87”
From The expanding role of GLP-1 receptor agonists: a narrative review of current evidence and future directions (2025) · cites this paper as [87]
Cites
Semaglutide, delayed gastric emptying, and intraoperative pulmonary aspiration: a case report
Klein, S. R., & Hobai, I. A. (2023) · Canadian Journal of Anesthesia/Journal canadien d'anesthésie · doi:10.1007/s12630-023-02440-3 · Cited by 207 · see citing works
Stark, J. E., Cole, J. L., Ghazarian, R. N., & Klass, M. J. (2022) · Annals of Pharmacotherapy · doi:10.1177/10600280211055804 · Cited by 77 · see citing works
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Moiz, A., Filion, K. B., Tsoukas, M. A., Yu, O. H. Y., Peters, T. M., & Eisenberg, M. J. (2025) · EClinicalMedicine · doi:10.1016/j.eclinm.2025.103363 · Cited by 157 · see citing works
Oprea, A. D., Ostapenko, L. J., Sweitzer, B., Selzer, A., Irizarry-Alvarado, J. M., Hurtado Andrade, M. D., Mendez, C. E., Kelley, K. D., Stewart, E., Fernandez Robles, C. R., et al. (2025) · British Journal of Anaesthesia · doi:10.1016/j.bja.2025.04.001 · Cited by 104 · see citing works
Self-citationAlkabbani, W., Suissa, K., Gu, K. D., Cromer, S. J., Paik, J. M., Bykov, K., Hobai, I., Thompson, C. C., Wexler, D. J., & Patorno, E. (2024) · BMJ · doi:10.1136/bmj-2024-080340 · Cited by 60 · see citing works
Al Sakka Amini, R., Ismail, A.-L. S., Al-Aqrabawi, M., Aleyadeh, W., Mohammed, A., Altork, N., Abosheaishaa, H., Elfert, K. A., Goble, S. R., Sawaf, B., et al. (2024) · Cureus · doi:10.7759/cureus.66311 · Cited by 13 · see citing works
- Authors
- Anazco, D., Fansa, S., Hurtado, M. D., Camilleri, M., & Acosta, A.
- Affiliations
- Mayo Clinic (US)
- Mayo Clinic in Florida (US)
- Corresponding author
- Acosta, Andres
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2024-06
- Volume
- 22
- Issue
- 6
- Pages
- 1333-1335.e2
- ISSN
- 1542-3565 (ISSN-L)
- OpenAlex
- W4389265703
- Cited by
- 58
- References
- 2
- Citations by year
- 2026: 8 · 2025: 27 · 2024: 23
- FWCI
- 11.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Mayo Clinic
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
- Keywords
- pulmonary aspiration, upper gastrointestinal endoscopy, GLP-1 receptor agonists, delayed gastric emptying, gastric retention, type 2 diabetes, obesity, endoscopic complications, incidence
- MeSH terms
- Glucagon-Like Peptide-1 Receptor, Glucagon-Like Peptide-1 Receptor Agonists, Aged, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemic Agents, Male, Middle Aged, Incidence, Endoscopy, Gastrointestinal, Respiratory Aspiration
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