Holding vs. Continuing Incretin-based Therapies Before Upper Endoscopy

NCT ID: NCT06533527

Last Updated: 2025-12-05

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

69 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-07-31

Study Completion Date

2025-05-20

Brief Summary

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To assess whether holding incretin-based therapy before endoscopy reduces the likelihood of clinically relevant Residual Gastric Volume (RGV).

Primary Outcomes:

* Residual gastric volume that precludes adequate endoscopic examination
* Residual gastric volume that necessitates premature termination of the endoscopy procedure
* Need for endotracheal intubation due to stomach contents.
* Occurrence of aspiration events requiring extended observation/monitoring, unplanned therapeutics, and/or hospital admission

Secondary Outcomes:

* Presence of any solid food
* Presence of moderate liquid content
* Increased RGV(Residual Gastric Volume) defined as any amount of solid content or \> 0.8 mL/Kg of fluid content (measured from the aspiration/suction canister).
* Differences in primary and secondary outcomes between different medications

Detailed Description

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Conditions

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Diabetes Mellitus, Type 2 Obesity Gastroparesis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

DOUBLE

Caregivers Investigators

Study Groups

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Continue medication as normal prior to endoscopic procedure

Does not withhold incretin therapy, maintains dose/frequency/duration of medication.

Group Type ACTIVE_COMPARATOR

GLP-1 medication

Intervention Type DRUG

Continue taking GLP-1 as normally scheduled prior to endoscopy.

Hold dose prior to endoscopic procedure

Withholds prior dose of incretin therapy per ASA guidance recommendations.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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GLP-1 medication

Continue taking GLP-1 as normally scheduled prior to endoscopy.

Intervention Type DRUG

Other Intervention Names

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Tirzepatide Semaglutide Liraglutide Dulaglutide

Eligibility Criteria

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Inclusion Criteria

* Patients using incretin-based therapies at a stable dose for more than 1 month.
* Patients scheduled for outpatient esophagogastroduodenoscopy (EGD), endoscopic ultrasound (EUS), or endoscopic retrograde cholangiopancreatography (ERCP) under monitored anesthesia care.

Exclusion Criteria

* Documented history of gastroparesis (based on a 4-hour solid-phase gastric emptying study)
* Known history of achalasia
* Surgical or genetically altered foregut anatomy
* Known gastric outlet obstruction or pre-procedure imaging suggestive of gastric outlet obstruction.
* Patients who did not follow the standard NPO (nil per oral) instructions.
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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The Cleveland Clinic

OTHER

Sponsor Role lead

Responsible Party

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Shah,Tilak

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Cleveland Clinic

Weston, Florida, United States

Site Status

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

Countries

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United States

References

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Kobori T, Onishi Y, Yoshida Y, Tahara T, Kikuchi T, Kubota T, Iwamoto M, Sawada T, Kobayashi R, Fujiwara H, Kasuga M. Association of glucagon-like peptide-1 receptor agonist treatment with gastric residue in an esophagogastroduodenoscopy. J Diabetes Investig. 2023 Jun;14(6):767-773. doi: 10.1111/jdi.14005. Epub 2023 Mar 15.

Reference Type RESULT
PMID: 36919944 (View on PubMed)

Silveira SQ, da Silva LM, de Campos Vieira Abib A, de Moura DTH, de Moura EGH, Santos LB, Ho AM, Nersessian RSF, Lima FLM, Silva MV, Mizubuti GB. Relationship between perioperative semaglutide use and residual gastric content: A retrospective analysis of patients undergoing elective upper endoscopy. J Clin Anesth. 2023 Aug;87:111091. doi: 10.1016/j.jclinane.2023.111091. Epub 2023 Mar 2.

Reference Type RESULT
PMID: 36870274 (View on PubMed)

Joshi G, Abdelmalak B, Weigel W, et al. American Society of Anesthesiologists Consensus-Based Guidance on Preoperative Management of Patients (Adults and Children) on Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists. Released June 29, 2023. Accessed from asahq.org on January 16, 2024.

Reference Type RESULT

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan: Protocol Ver. 5

View Document

Other Identifiers

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24-301

Identifier Type: -

Identifier Source: org_study_id

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