Glucagon-Like Peptide-1 Receptor Agonist Cases Reported to United States Poison Centers, 2017-2022

J Med Toxicol. 2024 Apr;20(2):193-204. doi: 10.1007/s13181-024-00999-x. Epub 2024 Feb 29.

Abstract

Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a class of medications for management of diabetes and obesity. The objective of this study is to characterize the epidemiology of GLP-1RA cases reported to US poison centers.

Methods: We analyzed cases involving a GLP-1RA reported to the National Poison Data System during 2017-2022.

Results: There were 5,713 single-substance exposure cases reported to US poison centers involving a GLP-1RA. Most cases were among females (71.3%) and attributable to therapeutic errors (79.9%). More than one-fifth (22.4%) of cases were evaluated in a healthcare facility, including 0.9% admitted to a critical care unit and 4.1% admitted to a non-critical care unit. Serious medical outcomes were described in 6.2% of cases, including one fatality. The rate of cases per one million US population increased from 1.16 in 2017 to 3.49 in 2021, followed by a rapid increase of 80.9% to 6.32 in 2022. Trends for rates of serious medical outcomes and admissions to a healthcare facility showed similar patterns with 129.9% and 95.8% increases, respectively, from 2021 to 2022.

Conclusions: Most GLP-1RA cases reported to US poison centers were associated with no or minimal effects and did not require referral for medical treatment; however, a notable minority of individuals experienced a serious medical outcome or healthcare facility admission. The rate of reported cases increased during the study period, including an 80.9% increase from 2021 to 2022. Opportunities exist to improve provider and patient awareness of the adverse effects of these medications.

Keywords: Adverse drug events; GLP-1 receptor agonist; Liraglutide; Semaglutide; Toxicity.

MeSH terms

  • Diabetes Mellitus, Type 2* / drug therapy
  • Female
  • Glucagon-Like Peptide-1 Receptor Agonists
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Liraglutide / therapeutic use
  • Liraglutide / toxicity
  • Poisons* / therapeutic use
  • United States / epidemiology

Substances

  • Hypoglycemic Agents
  • Liraglutide
  • Glucagon-Like Peptide-1 Receptor Agonists
  • Poisons