18 - Predictors of Pancreatitis on Initiation of GLP-1 Receptor Agonists for Weight Loss

Robert Postlethwaite, MD, Amin Amin, MD, Jaime Almandoz, MD, Tarek Sawas, MD, MPH
University of Texas Southwestern, Dallas, TX

Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have revolutionized management of obesity. GLP-1RAs are widely prescribed for treating obesity and its associated comorbidities, including type 2 diabetes mellitus (T2DM). Although GLP-1RAs demonstrate a favorable side effect profile compared to other types of anti-obesity medications, acute pancreatitis (AP) remains a serious and sometimes life-threatening adverse effect. Unfortunately, there is a paucity of data regarding which patients may be at increased risk of developing AP from GLP-1RAs. The purpose of this study is to identify patient factors that impact the risk of AP after initiation of GLP-1RA treatment for obesity.

Methods: We performed a retrospective single-center study in patients seen at an academic institution’s Weight Wellness program between 1/1/2015 and 12/31/2021. We identified patients initiated on GLP-1RAs and stratified them based on the development of AP. Chart review obtained baseline patient characteristics, medical comorbidities, and surgical history. A multivariable logistic regression model was used to identify the predictors of AP with GLP-1RA use. All statistical analyses were performed using STATA 14.2.

Results: There were 2,245 patients included. The average age was 49.5 years old and 1,807 (80.5%) were female. The average body mass index (BMI) of all patients was 39.7 kg/m². Of the 2,245 patients, 49 (2.2%) developed AP after starting a GLP-1RA. A history of T2DM (adjusted odds ratio (aOR) 2, 95% CI: 1.04-3.96, P=0.04), tobacco use (aOR 3.3, 95% CI: 1.70-6.50, P< 0.001), and advanced (≥ stage 3) CKD (aOR 2.3, 95% CI: 1.18-4.55, P=0.01) were associated with a higher risk of AP with GLP-1RA use. Compared to patients with a BMI ≤30 kg/m², those with a BMI 36-40 and BMI >40 were associated with a lower risk of AP after GLP-1RA use with an aOR of 0.22 (95% CI: 0.07-0.67, p=0.007) and 0.27 (95% CI: 0.10-0.73, P=0.01), respectively. There was no association between age, sex, history of bariatric surgery, or history of AP and the development of AP after GLP-1RA use.

Discussion: Our study suggests that a history of T2DM, tobacco use, and advanced CKD increases the risk of AP after initiation of GLP-1RA for obesity treatment. A higher BMI appears to be protective against AP. Recognizing the predictive factors of GLP-1RA-associated AP can inform clinicians on risk stratification and symptom monitoring.



Disclosures:


Robert Postlethwaite, MD, Amin Amin, MD, Jaime Almandoz, MD, Tarek Sawas, MD, MPH, 18, Predictors of Pancreatitis on Initiation of GLP-1 Receptor Agonists for Weight Loss, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.