The Impact of GLP-1 Receptor Agonists on Esophagogastroduodenoscopy Outcomes: A Retrospective Cohort Study in a Predominantly African American Population.

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) improve glycemic control and promote weight loss but may increase gastric residue, raising concerns during esophagogastroduodenoscopy (EGD). African American patients remain underrepresented in research on these agents. Methods: We performed a retrospective cohort study at a single tertiary referral center, including adults (≥ 18 years) undergoing elective EGD. Participants were divided into two groups based on documented GLP-1 RA use within 7 days of EGD versus no use. Outcomes included the presence of residual gastric contents, procedure abortion due to gastric residue, procedural bleeding, and post-procedural hospitalization. We applied multiple imputation for missing data and entropy balancing for covariate adjustment, reporting odds ratios (OR) and 95% confidence intervals (CI). Results: Among 1408 participants, 270 used GLP-1 RAs. Compared to non-users, GLP-1 RA users had a higher mean body mass index (33 vs. 30 kg/m Conclusion: In this predominantly African American cohort, recent GLP-1 RA therapy did not significantly elevate intra-procedural risk or necessitate procedure abortion. These findings suggest that routine discontinuation of GLP-1 RAs prior to EGD may not be universally required, especially for patients benefiting from improved metabolic control. Larger prospective studies are warranted to inform guideline updates for diverse patient populations.