FAERS analysis links GLP-1RAs, female sex, and younger age to increased drug-related impaired gastric emptying

Pulmonary aspiration during surgery remains a significant patient safety concern, often linked to impaired gastric emptying (IGE). While drug-related IGE is a known risk, its prevalence and specific triggers are underappreciated. The rising use of medications like glucagon-like peptide-1 receptor agonists (GLP-1RAs) for diabetes and weight management has heightened concerns about their potential to delay gastric emptying, thereby increasing aspiration risk. This study addresses the gap in real-world data on specific drug-related IGE risk factors.

A retrospective pharmacovigilance study analyzed real-world data from the FDA Adverse Event Reporting System (FAERS) spanning Q1 2004 through Q2 2025. Researchers performed disproportionality analysis, logistic regression, LASSO regression, and time-to-onset analysis to identify associations between drugs and IGE. The analysis aimed to pinpoint independent risk factors for drug-related IGE from various perspectives. The study did not involve direct patient intervention but rather analyzed reported adverse events.

The analysis identified 731 drugs associated with IGE. Notably, six of the top 10 most frequently reported drugs linked to IGE were antidiabetic agents, with five being GLP-1RAs: semaglutide, dulaglutide, tirzepatide, exenatide, and liraglutide. Multi-factor analysis revealed that female sex, age <63 years, and exposure to any of nine specific drugs were independent risk factors for drug-related IGE. These drugs included the GLP-1RAs, insulin lispro, sodium oxybate, olmesartan, and esomeprazole. The predictive model demonstrated good discriminatory capability with an ROC-AUC of 0.739. Time-to-onset analysis indicated an early-failure pattern for all nine identified drugs. This suggests that IGE events, when they occur, tend to manifest relatively soon after drug initiation.

Female sex, age <63 years, and specific medications (including GLP-1RAs) were identified as independent risk factors for drug-related impaired gastric emptying.