GLP-1s patients more likely to develop GERD

The incidence of gastroesophageal reflux disease (GERD) is higher among people taking glucagon-like peptide-1 receptor agonists (GLP-1 RAs) compared with those taking sodium-glucose cotransporter-2 (SGLT-2) inhibitors, according to researchers from McGill University and Lady Davis Institute, Jewish General Hospital in Montreal, Canada.

Credit: BruceBlaus

The researchers designed a population-based cohort study emulating a target trial that estimated the effect of GLP-1 RAs and SGLT-2 inhibitors on the risk for GERD and its complications in patients with type 2 diabetes.

The study included 24,708 new users of GLP-1 RAs who had a median follow-up of three years and 89,096 new users of SGLT-2 inhibitors who had a median follow-up of 2.7 years. The primary outcome was a diagnosis of GERD and the secondary outcome was complications of GERD. The researchers found that during follow-up the incidence rate for GERD was 7.9 per 1,000 person years. In total, there were 138 complications of GERD were observed, with more than 90% of them being Barrett oesophagus.

At three-year follow-up, the risk ratio (RR) was 1.27 for GERD and 1.55 for GERD complications in GLP-1 RA users compared with SGLT-2 inhibitor users. Secondary analyses found that risks for GERD were higher overall for each GLP-1 RA type except lixisenatide, and risks for GERD complications were higher in smokers, patients with obesity, and patients with gastric comorbidities.

The researchers said these findings demonstrate that clinicians and patients should be aware of the possible adverse effect of GLP-1 RAs on GERD.

The findings were published in the paper, ‘Glucagon-Like Peptide-1 Receptor Agonists and Risk for Gastroesophageal Reflux Disease in Patients With Type 2 Diabetes’, published in the Annals of Internal Medicine. To access this paper, please click here (log-in maybe required)