New studies have found that taking popular diabetes and weight loss drugs like Ozempic and Wegovy may increase the risk of stomach paralysis. (Read this also | ICMR said to avoid rapid weight loss and obesity medicines; also told how much weight loss per week is safe,
Stomach paralysis, also known as gastroparesis, weakens the stomach muscles, causing food to sit in the main digestive organ for long periods of time.
Wegovy is approved by the US Food and Drug Administration (FDA) for weight management, while Ozempic is an approved drug that helps patients with type 2 diabetes manage blood sugar levels.
However, Ozempic is sometimes prescribed for weight loss, even though it is not approved by the FDA for this purpose. Both Wegovy and Ozempic are injections that contain the protein semaglutide, which is similar to the hormone glucagon-like peptide-1 (GLP-1).
One of the main actions of GLP-1 released in the body in response to food intake is stimulating the production of insulin.
While these antidiabetic and weight loss drugs, known as GLP-1 receptor agonists or GLP-1 analogs, tend to cause gastrointestinal (GI) side effects such as nausea, vomiting, and diarrhea, new studies suggest that less common side effects such as stomach paralysis (gastroparesis), ileus, and acute pancreatitis may also occur.
These studies were presented at Digestive Diseases Week 2024, a conference held from May 18-21 in Washington DC, US.
One of these studies, conducted by researchers, including those from the University of Kansas, identified 1.85 lakh patients with diabetes or obesity who were prescribed GLP-1 analogs between December 1, 2021, and November 30, 2022.
About 0.53 percent of patients were found to develop gastroparesis, and the research team estimated that the risk of this condition increased by 66 percent.
Cholecystitis (inflammation of the gallbladder) was reported in 0.55 percent of patients, and the risk of developing this disease was estimated to increase to 28 percent.
The study authors also found that 0.04 percent of GLP-1 analog-prescribed patients developed drug-induced pancreatitis, and estimated that the risk of the condition increased by more than 350 percent.
They also found that the incidence of nausea and vomiting was significantly higher at 9 percent of patients, while 7.5 percent had a higher incidence of gastro-oesophageal reflux disease (GERD), a condition in which the contents of the stomach move up into the food pipe or oesophagus.
The results showed that “the use of GLP-1 agonists in patients with diabetes and obesity is associated with GI side effects, including nausea, vomiting, gastroparesis, GERD, esophagitis, drug-induced pancreatitis, cholecystitis, and the need for upper-endoscopy,” the authors wrote in the study, which is currently available as an abstract.
The second study assessed the risk of gastroparesis in patients with type 2 diabetes treated with GLP-1 receptor agonists (RA). Over 3.36 lakh patients were included in each of the two groups – one receiving the drug and the other not.
“Patients with T2D prescribed GLP-1 RAs had an increased risk of GP at 6, 9, 12, 18, and 24 months. The odds ratio for gastroparesis increased significantly from 6 months to 24 months after control for various risk factors,” the authors, from the Cleveland Clinic in Ohio, wrote in the study abstract. Both studies used data from TriNetX, a multi-institutional database.
The third study, conducted by researchers at Mayo Clinic Minnesota, assessed the effect of GLP-1 RAs on GI symptoms. This analysis included data from the Mayo Clinic platform from nearly 80,000 patients who were prescribed the drug.
The researchers found that about 14,660 of these patients, or 18 percent, developed at least one new GI symptom suggestive of gastroparesis. About 700 of the 14,660 patients underwent gastric emptying scintigraphy (GES), which helps assess the ability of the stomach to empty.
The team found that about a third of this group had gastroparesis.
“These real-world data suggest that GI symptoms are more common in people treated with GLP-1 RAs,” the authors wrote in the study’s summary.
