Researchers at Cedars-Sinai have conducted a study suggesting that patients should temporarily halt the intake of weight management drugs such as Ozempic and Wegovy before undergoing endoscopy procedures to reduce the risk of aspiration pneumonia. These drugs, known as glucagon-like peptide-1 receptor agonists (GLP-1RAs), slow down digestion and prolong the feeling of fullness, which can lead to food retention in the stomach. This prolonged presence of food increases the chances of aspiration pneumonia, especially during endoscopy procedures, where a tube is inserted through the throat to observe internal organs such as the esophagus and stomach.
The study involved nearly 1 million patients in the United States and was published in Gastroenterology. It identified a higher risk of aspiration pneumonia in patients taking weight-management drugs like Ozempic and Wegovy due to the delayed emptying of the stomach during fasting periods before surgical interventions. Aspiration pneumonia occurs when foreign substances, such as food or secretions, are inhaled into the lungs, leading to airway and lung infections that require treatment with antibiotics. Although aspiration pneumonia is rare in healthy individuals, it is more common among those with pre-existing health conditions.
Dr. Ali Rezaie from Cedars-Sinai explained that weight loss medications like Ozempic work by slowing down food passage through the gastrointestinal tract, leading to a higher risk of excessive food residual in the stomach. This leftover food can reflux into the airways and lungs during sedation for procedures, causing aspiration pneumonia. Despite the overall low risk of aspiration, taking these medications can increase the chances of aspiration pneumonia by 33%, which can be reduced by temporarily discontinuing the medication before the procedure, as advised by healthcare providers.
Dr. Jared L. Ross, a professor and medical director at Henry Ford College Paramedic Program, emphasized the importance of discussing medication use with healthcare providers before procedures, particularly when taking GLP-1 agonists like Ozempic. He highlighted that these drugs delay gastric emptying, which can increase the risk of gastric aspiration, especially during endoscopy procedures where sedating medications are used. The study, which analyzed data from almost 1 million patients undergoing endoscopy procedures, did not consider patient age, which could affect the likelihood of regurgitating stomach contents and developing pneumonia from aspiration.
Dr. Ross stressed the need for further research in this area to better understand patient risks based on age and overall health status. While the study underscores the importance of weighing the risk and benefits of stopping weight management medications before procedures, more evidence is needed to provide tailored recommendations for patients. Dr. Rezaie highlighted the potential impact of temporarily halting weight-loss medications before endoscopic procedures, suggesting that this practice could prevent thousands of hospitalizations and save lives. He emphasized the importance of being aware of potential side effects of weight-loss medications to optimize their positive effects on health outcomes.
