Submission
| Title: | The Impact of Preoperative Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RA) Utilization on Bariatric Surgery Outcomes |
| Presenter: | Tarik Yuce |
| Institution: | Indiana University School of Medicine |
| Authors: | Qais AbuHasan, MD1, Daniel E Kpormegbey, PhD2, Luke M Funk, MD, MPH3, David B Allison, PhD2, Jane L Holl, MD, MPH1,4, Dimitrios Stefanidis, MD, PhD1, Tarik K Yuce, MD, MS1
1 Department of Surgery, Indiana University School of Medicine, Indianapolis, IN |
Abstract
| Background/Significance/Rationale: | The efficacy of GLP1RA for the treatment of obesity has led to considerably increased demand for GLP1RA. GLP1RA use prior to bariatric surgery may represent a novel approach to treating obesity. The objectives of this study were to (1) describe trends in pre-bariatric GLP1RA use, (2) investigate social and clinical factors associated with their use, and (3) evaluate differences in clinical outcomes based on preoperative GLP1RA use. |
| Methods: | Patients who underwent bariatric surgery at three Indiana hospitals from 2018-2023, were identified. Patients who utilized GLP1RA in the year preceding surgery were compared to those who did not. Social determinants of health included insurance, income, and unemployment. Outcomes included rates of GLP1RA use, 30-day postoperative readmissions, ED visits, and percent total weight lost (%TWL) at one year. Associations between preoperative GLP1RA use and outcomes of interest were evaluated using multivariable logistic and linear regressions. |
| Results/Findings: | Of 2,169 patients who underwent surgery, 293 (13.5%) utilized GLP1RA preoperatively. The rate of GLP1RA utilization increased threefold from 2018-2023. Males were more likely to receive preoperative GLP1RA (20.1% vs, 12.2%, p<0.001). There were no significant differences in social determinants of health or 30-day postoperative outcomes between patients who did and did not use GLP1RA preoperatively. Similarly, there were no significant differences in %TWL at one year postoperatively between groups (median 25.5% vs. 27.3%, coefficient: -0.78, 95%CI: -2.26-0.70). |
| Conclusions/Discussion: | Utilization of GLP1RA in the year prior to bariatric surgery has significantly increased. Preoperative GLP1RA use is not associated with worse 30-day outcomes or differences in %TWL at one year postoperatively. Further work is needed to evaluate whether GLP1RA dosing and duration of treatment impact postoperative outcomes. |
| Translational/Human Health Impact: | The use of GLP1RA prior to bariatric surgery may represent a novel method for preoperative optimization, lending further support to efforts seeking to improve access to these medications for the treatment of obesity. |
