{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T07:40:41Z","timestamp":1792395641622,"version":"4.4.0"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Gastrointestinal symptom events (GISE) are common with glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101RA). We aimed to determine the prevalence of GISE and clinical factors associated with GISE.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n An integrated platform database was used to collect real\u2010world data. Using a retrospective cohort study design, Kaplan\u2013Meier analysis was used to estimate GISE\u2010free survival over 60\u2009months. To identify predictors of GISE, the cohort was randomly split 80\/20 into training and testing sets. A LASSO\u2010penalized Cox model was used to identify relevant associations, after which main\u2010effect and interaction models were constructed. Gastric emptying scintigraphy (GES) of solids was extracted from electronic medical records, where available.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 78,277 patients, 87% reported no baseline GI symptoms. At 60\u2009months, 53% reported at least one GISE, most commonly abdominal pain (28%) and nausea (25%). Women were at higher risk of GISE than men (Kaplan\u2013Meier HR 1.4). In the prediction model, baseline diarrhea, constipation, abdominal pain, and nausea were associated with higher GISE risk (HRs 2.2, 2.0, 1.7, and 1.6, respectively), and male sex with lower risk (HR 0.79). Concomitant baseline use of metoclopramide (HR 1.6) was also associated with higher risk of GISE, with weaker associations for tricyclic antidepressants, GABA analogs, and opioids (HRs 1.1\u20131.2). Model discrimination was modest (C\u2010index 0.64 training, 0.63 testing). Among 696 symptomatic patients clinically referred for GES after GLP\u20101RA initiation, 34.6% (\n N<\/jats:italic>\n \u2009=\u2009241) exhibited delayed GE. Constipation was more prevalent in those with delayed GE.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The 5\u2010year incidence of GISE among patients initiating GLP\u20101RA therapy was over 50%. While the ability to predict GISE was modest, female sex, baseline GI symptoms, and concomitant medications were associated with an increased risk. Among the small, symptom\u2010selected subgroup referred for testing, only a third had delayed GE.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/nmo.70458","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T06:53:07Z","timestamp":1792392787000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gastrointestinal Symptom Events and Motility Alterations Associated With\n GLP<\/scp>\n \u20101 Receptor Agonists"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4659-3468","authenticated-orcid":false,"given":"Julio Zuniga","family":"Cisneros","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Lupianez\u2010Merly","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2027-7405","authenticated-orcid":false,"given":"Saam","family":"Dilmaghani","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8366-8422","authenticated-orcid":false,"given":"Ryan J.","family":"Lennon","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Then","sequence":"additional","affiliation":[{"name":"Mayo Clinic Platform, Mayo Clinic Rochester Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phil","family":"Fiero","sequence":"additional","affiliation":[{"name":"Mayo Clinic Platform, Mayo Clinic Rochester Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"Blundo","sequence":"additional","affiliation":[{"name":"Mayo Clinic Platform, Mayo Clinic Rochester Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3473-5235","authenticated-orcid":false,"given":"Gianrico","family":"Farrugia","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6472-7514","authenticated-orcid":false,"given":"Michael","family":"Camilleri","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5092-0831","authenticated-orcid":false,"given":"Madhusudan","family":"Grover","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.obpill.2024.100127","article-title":"Glucagon\u2010Like Receptor\u20101 Agonists for Obesity: Weight Loss Outcomes, Tolerability, Side Effects, and Risks","volume":"12","author":"Ghusn W.","year":"2024","journal-title":"Obesity Pillars"},{"issue":"1","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41392-024-01931-z","article-title":"Glucagon\u2010Like Peptide\u20101 Receptor: Mechanisms and Advances in Therapy","volume":"9","author":"Zheng 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H.","year":"2021","journal-title":"New England Journal of Medicine"},{"issue":"2","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.diabet.2019.101117","article-title":"Efficacy and Safety of Once\u2010Weekly Semaglutide 1.0 mg vs Once\u2010Daily Liraglutide 1.2 mg as Add\u2010On to 1\u20133 Oral Antidiabetic Drugs in Subjects With Type 2 Diabetes (SUSTAIN 10)","volume":"46","author":"Capehorn M. S.","year":"2020","journal-title":"Diabetes & Metabolism"},{"key":"e_1_2_11_12_1","first-page":"13","article-title":"Association Between Different GLP\u20101 Receptor Agonists and Gastrointestinal Adverse Reactions: A Real\u2010World Disproportionality Study Based on FDA Adverse Event Reporting System Database","volume":"13","author":"Liu L.","year":"2022","journal-title":"Frontiers in Endocrinology"},{"key":"e_1_2_11_13_1","doi-asserted-by":"crossref","unstructured":"S.Delgado\u2010Aros D. Y.Kim D. D.Burton et\u00a0al. \u201cEffect of GLP\u20101 on Gastric Volume Emptying Maximum Volume Ingested and Postprandial Symptoms in Humans \u201d282 no.3 45\u20103(2002) https:\/\/doiorg\/101152\/ajpgi20022823G424.","DOI":"10.1152\/ajpgi.2002.282.3.G424"},{"issue":"6","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.14309\/ajg.0000000000002820","article-title":"Quantified Metrics of Gastric Emptying Delay by Glucagon\u2010Like Peptide\u20101 Agonists: A Systematic Review and Meta\u2010Analysis With Insights for Periprocedural Management","volume":"119","author":"Hiramoto B.","year":"2024","journal-title":"American Journal of Gastroenterology"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"27(1)","DOI":"10.1007\/s11894-025-00995-3","article-title":"Gastrointestinal Motility Effects of GLP\u20101 Receptor Agonists","volume":"27","author":"Bellavance D.","year":"2025","journal-title":"Current Gastroenterology Reports"},{"issue":"10","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"1946","DOI":"10.1038\/s41366-025-01859-6","article-title":"Gastrointestinal Adverse Events Associated With GLP\u20101 RA in Non\u2010Diabetic Patients With Overweight or Obesity: A Systematic Review and Network Meta\u2010Analysis","volume":"49","author":"Ismaiel A.","year":"2025","journal-title":"International Journal of Obesity"},{"issue":"2","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1002\/oby.23941","article-title":"Prevalence and Variations in Gastric Emptying Delay in Response to GLP\u20101 Receptor Agonist Liraglutide","volume":"32","author":"Camilleri M.","year":"2024","journal-title":"Obesity (Silver Spring, Md)"},{"issue":"5","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.2337\/db10-0474","article-title":"Rapid Tachyphylaxis of the Glucagon\u2010Like Peptide 1\u2010Induced Deceleration of Gastric Emptying in Humans","volume":"60","author":"Nauck M. 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A.","year":"2018","journal-title":"Gastroenterology"},{"issue":"9","key":"e_1_2_11_31_1","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.2337\/dc20-0720","article-title":"Effects of Lixisenatide Versus Liraglutide (Short\u2010 and Long\u2010Acting GLP\u20101 Receptor Agonists) on Esophageal and Gastric Function in Patients With Type 2 Diabetes","volume":"43","author":"Quast D. R.","year":"2020","journal-title":"Diabetes Care"},{"issue":"1","key":"e_1_2_11_32_1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1185\/03007995.2015.1103214","article-title":"The Value of Short\u2010 and Long\u2010Acting Glucagon\u2010Like Peptide\u20101 Agonists in the Management of Type 2 Diabetes Mellitus: Experience With Exenatide","volume":"32","author":"Guo X. 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