Effect of Glucagon-Like Peptide-1 Receptor Agonists on Bowel Preparation for Colonoscopy: A Systematic Review and Meta-Analysis.

Beran, Azizullah; Nayfeh, Tarek; Akhras, Aya; Ramai, Daryl; Mohamed, Mouhand; Guardiola, John J; Al-Haddad, Mohammad; Rex, Douglas K · Am J Gastroenterol · 2025

meta_analysis · Level I

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Abstract

The impact of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on colonoscopy bowel preparation is unclear. We searched multiple databases for studies comparing bowel preparation quality between GLP-1RA users and the control group. Using a random-effects model, we calculated pooled odds ratios and mean differences with 95% confidence intervals (CIs). Inadequate bowel preparation (IBP) rate was the primary outcome, and Boston Bowel Preparation Scale mean score was the secondary outcome. Five studies with 10,833 patients (n = 5,434 GLP-1RAs vs n = 5,399 control) were included. The IBP rate was higher in the GLP-1RAs group compared with the control group (odds ratios 2.10, 95% CI 1.41-3.13, P = 0.0003). Furthermore, the mean Boston Bowel Preparation Scale score was lower in the GLP1-RAs group compared with the control group (mean differences -0.34; 95% CI -0.51, -0.17; P = 0.0001). Our findings suggest that using GLP-1RA increases the risk of IBP.

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