Neurogastroenterology and Motility · Nov 5, 2026

Similar Tolerance of Glucagon‐Like PEPTIDE‐1 Agonist Therapy in Patients With Delayed and Normal Gastric Emptying

By Rolak SC, Lunsford TN, Frazier RD et al.

Introduction: Gastroparesis is considered a relative contraindication to glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) prescription. We examined outcomes of patients who underwent gastric scintigraphy to determine if emptying delays adversely affected tolerance of subsequent GLP‐1RA therapy. Methods: Patients with delayed (DGE) and normal (NGE) gastric emptying who were subsequently prescribed GLP‐1RAs were identified. GLP‐1RA prescribing profiles, gastrointestinal (GI) symptoms and treatments, and GLP‐1RA discontinuation were compared between patients with DGE versus NGE. Key Results: Eighty‐one patients were prescribed GLP‐1RAs after scintigraphy; 14/81 (17%) with DGE and 67/81 (83%) with NGE. Injectable semaglutide was most often prescribed and was taken at similar doses for DGE (11/14, 79%) and NGE (40/67, 60%) ( p = 0.23). GLP‐1RAs were initiated a median of 386 days (IQR 190, 474) after scintigraphy with DGE versus 315 days (IQR 157, 613) with NGE ( p = 0.86). GI symptoms developed in 5/14 (36%) with DGE versus 35/67 (52%) with NGE ( p = 0.38) and antiemetic ( p = 0.75) and prokinetic ( p = 1.00) use was similar between groups. GLP‐1RAs were discontinued in 45/81 (56%) patients including 14/45 (31%) for GI symptoms, which occurred similarly for DGE (3/8, 38%) and NGE (11/37, 30%) ( p = 0.70). Treatment durations were similar with DGE (318 days [IQR 223, 464]) versus NGE (193 days [IQR 83, 363]) ( p = 0.31). Conclusions and Inferences: GLP‐1RAs are taken at similar doses for similar durations, elicit similar symptoms, and are discontinued for similar reasons in patients with prior delayed versus normal gastric emptying. These observations do not support strictly avoiding GlP‐1RAs in gastroparesis and suggest they may be safely prescribed in many cases.

doi.org/10.1111/nmo.70448Open accessPubMed 42989430Interventions