ABSTRACT 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 2 ) and hemoglobin A1c (7.43% vs. 6.54%). In the adjusted analysis, GLP‐1 RA treatment was not significantly associated with increased gastric content (OR, 1.52; 95% CI, 0.58–3.99; p = 0.395) or other procedural complications. Conversely, GLP‐1 RA use was linked to lower post‐procedural hospitalization rates (OR, 0.19; 95% CI, 0.06–0.58; p = 0.004). 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.
Sabagh et al. (Sun,) studied this question.