Studies examining the risks of GLP-1 weight-loss drugs, distinguishing alpha-gal syndrome from other GI disorders, and comparing medications to slow the progression of liver disease in patients with alcohol-use disorder will be presented this week at Digestive Disease Week (DDW) 2024.
Here are summaries of the new research:
Re-examining the risks of gastrointestinal adverse events associated with glucagon-like peptide-1 receptor agonists for weight loss with more stringent criteria on a comprehensive large database, Abstract 1074
This retrospective study re-examined the association found in a recent study (published in JAMA, October 2023) between GLP-1 weight loss drugs and pancreatitis, gastroparesis and bowel obstruction by incorporating BMI data that was not calibrated in the previous study. Contradicting the original publication, researchers did not find a relationship between GLP-1s and acute pancreatitis or bowel obstruction, but some increased risk of biliary disease and gastroparesis was observed.
Clinical presentation and outcomes of alpha-gal syndrome: A tertiary care single-center experience, Abstract 485
Of 1,260 patients undergoing testing for alpha-gal syndrome at Mayo Clinic from 2014-2023, 124 tested positive for alpha-gal and were compared to 380 randomly obtained negative patients. Patients with positive blood tests for alpha-gal syndrome had greater risk of urticaria and anaphylaxis, and decreased risk of heartburn and bloating compared to those with negative tests. Female patients with alpha-gal syndrome were more likely to have GI symptoms. Researchers conclude that an alpha-gal syndrome diagnosis should be considered in GI patients, especially females, with a history of tick bites and associated symptoms of urticaria and anaphylaxis. Symptoms like GERD, bloating and a history of asthma are less likely to be associated with alpha-gal syndrome. Nearly 90% of patients showed improvement or resolution of alpha-gal symptoms, especially on a restricted diet, but less than a third had blood tests that were negative for alpha-gal.
Association of acamprosate vs. gabapentinoids and liver disease progression in patients with alcohol-use disorder, Abstract 750
Although acamprosate has been approved for the treatment of alcohol use disorder, gabapentinoids have been used off-label for the same purpose. This study found that gabapentinoids were associated with slower progression of alcoholic liver disease than acamprosate, and gabapentinoids may be a valuable option for the treatment of alcohol use disorder. Researchers examined medical records for 24,477 matched pairs of acamprosate and gabapentinoids users from a veterans’ health database and found liver disease progressed in 15.78% of acamprosate users compared to 13.37% of gabapentinoid users. Compensated cirrhosis and decompensated cirrhosis outcomes were also similar or better among gabapentinoid users.