Chino Aneke-Nash, Kay Su Hung, Elizabeth Wall-Wieler, Feibi Zheng, Reem Z Sharaiha
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The incidence of gastroparesis diagnosis was evaluated using International Classification of Diseases, Version 10 codes. The risk of gastroparesis was compared between three intervention groups using Cox proportional hazards regression models.</p><p><strong>Results: </strong>Of the 55 460 individuals included, 36 990 (66.7%) were treated with semaglutide, 7369 (13.3%) with bupropion-naltrexone and 11 101 (13.7%) with sleeve gastrectomy. Gastroparesis rates among those treated with semaglutide versus bupropion-naltrexone versus sleeve gastrectomy were 6.5 per 1000 person-years (PY) vs 2.1 per 1000 PY vs 1.1 per 1000 PY, respectively. After adjusting for baseline characteristics, individuals treated with semaglutide had a higher risk of gastroparesis than those treated with bupropion-naltrexone (adjusted HR 3.33, 95% CI 2.27, 4.98) and sleeve gastrectomy (adjusted HR 6.14, 95% CI 3.94, 9.57).</p><p><strong>Conclusions: </strong>There is an increased incidence of gastroparesis among individuals with obesity without T2D who are using semaglutide as compared with bupropion-naltrexone and sleeve gastrectomy. Understanding these potential side effects, though rare, may help guide personalised treatment regimens.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"12 1","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966946/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparing the risk of gastroparesis following different modalities for treating obesity: semaglutide versus bupropion-naltrexone versus sleeve gastrectomy - a retrospective cohort study.\",\"authors\":\"Chino Aneke-Nash, Kay Su Hung, Elizabeth Wall-Wieler, Feibi Zheng, Reem Z Sharaiha\",\"doi\":\"10.1136/bmjgast-2024-001704\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The use of glucagon-like peptide 1 receptor agonists has been associated with gastroparesis, but little is known about the risk of gastroparesis in those with obesity but without type 2 diabetes (T2D), and how that risk compares with other treatment modalities for obesity. This study aims to characterise the relationship between different treatment modalities for obesity and the risk of gastroparesis in a population without pre-existing T2D.</p><p><strong>Methods: </strong>A retrospective cohort study using Merative MarketScan Research Databases of individuals with obesity who underwent treatment with semaglutide, bupropion-naltrexone or sleeve gastrectomy from 1 January 2018 to 31 December 2022. The incidence of gastroparesis diagnosis was evaluated using International Classification of Diseases, Version 10 codes. The risk of gastroparesis was compared between three intervention groups using Cox proportional hazards regression models.</p><p><strong>Results: </strong>Of the 55 460 individuals included, 36 990 (66.7%) were treated with semaglutide, 7369 (13.3%) with bupropion-naltrexone and 11 101 (13.7%) with sleeve gastrectomy. 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引用次数: 0
摘要
目的：胰高血糖素样肽1受体激动剂的使用与胃轻瘫有关，但对肥胖但无2型糖尿病（T2D）的胃轻瘫风险知之甚少，以及该风险与其他肥胖治疗方式的比较。本研究旨在描述在没有t2dm的人群中，不同的肥胖治疗方式与胃轻瘫风险之间的关系。方法：使用Merative MarketScan研究数据库对2018年1月1日至2022年12月31日期间接受西马鲁肽、安非他酮-纳曲酮或袖式胃切除术治疗的肥胖患者进行回顾性队列研究。胃轻瘫的发病率诊断评估使用国际疾病分类，版本10代码。采用Cox比例风险回归模型比较三个干预组胃轻瘫的风险。结果：纳入的55460例患者中，36 990例（66.7%）接受了西马鲁肽治疗，7369例（13.3%）接受了安非他酮-纳曲酮治疗，11 101例（13.7%）接受了套管胃切除术。在西马鲁肽治疗组、安非他酮治疗组和套筒胃切除术组中，胃轻瘫发生率分别为6.5 / 1000人年（PY）、2.1 / 1000人年和1.1 / 1000人年。在调整基线特征后，接受西马鲁肽治疗的患者发生胃轻瘫的风险高于接受安非他酮-纳曲酮治疗的患者（调整后危险度3.33,95% CI 2.27, 4.98）和套管胃切除术的患者（调整后危险度6.14,95% CI 3.94, 9.57）。结论：与安非他酮-纳曲酮和袖式胃切除术相比，使用西马鲁肽的肥胖无T2D患者胃轻瘫发生率增加。了解这些潜在的副作用，虽然罕见，但可能有助于指导个性化的治疗方案。
Comparing the risk of gastroparesis following different modalities for treating obesity: semaglutide versus bupropion-naltrexone versus sleeve gastrectomy - a retrospective cohort study.
Objective: The use of glucagon-like peptide 1 receptor agonists has been associated with gastroparesis, but little is known about the risk of gastroparesis in those with obesity but without type 2 diabetes (T2D), and how that risk compares with other treatment modalities for obesity. This study aims to characterise the relationship between different treatment modalities for obesity and the risk of gastroparesis in a population without pre-existing T2D.
Methods: A retrospective cohort study using Merative MarketScan Research Databases of individuals with obesity who underwent treatment with semaglutide, bupropion-naltrexone or sleeve gastrectomy from 1 January 2018 to 31 December 2022. The incidence of gastroparesis diagnosis was evaluated using International Classification of Diseases, Version 10 codes. The risk of gastroparesis was compared between three intervention groups using Cox proportional hazards regression models.
Results: Of the 55 460 individuals included, 36 990 (66.7%) were treated with semaglutide, 7369 (13.3%) with bupropion-naltrexone and 11 101 (13.7%) with sleeve gastrectomy. Gastroparesis rates among those treated with semaglutide versus bupropion-naltrexone versus sleeve gastrectomy were 6.5 per 1000 person-years (PY) vs 2.1 per 1000 PY vs 1.1 per 1000 PY, respectively. After adjusting for baseline characteristics, individuals treated with semaglutide had a higher risk of gastroparesis than those treated with bupropion-naltrexone (adjusted HR 3.33, 95% CI 2.27, 4.98) and sleeve gastrectomy (adjusted HR 6.14, 95% CI 3.94, 9.57).
Conclusions: There is an increased incidence of gastroparesis among individuals with obesity without T2D who are using semaglutide as compared with bupropion-naltrexone and sleeve gastrectomy. Understanding these potential side effects, though rare, may help guide personalised treatment regimens.
期刊介绍：
BMJ Open Gastroenterology is an online-only, peer-reviewed, open access gastroenterology journal, dedicated to publishing high-quality medical research from all disciplines and therapeutic areas of gastroenterology. It is the open access companion journal of Gut and is co-owned by the British Society of Gastroenterology. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around continuous publication, publishing research online as soon as the article is ready.
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