Ann Intern Med

GLP-1s linked to increased reflux risk in patients with T2DM

July 22, 2025

GLP-1 RAs may be associated with higher GERD risk than SGLT-2 inhibitors in adult patients with T2DM, according to this database trial emulation study on new users of these drugs.

Study details. This active-comparator study examined records in the U.K. Clinical Practice Research Datalink to compare adults with T2DM initiating GLP-1 RAs (N=24,708) vs. SGLT-2 inhibitors (N=89,096), 2013-2021. Primary outcome: incident GERD. Secondary outcome: GERD complications. Propensity score fine stratification was used to adjust for confounding; follow-up was a median of 3 years.

Results. GLP-1 RA use was associated with a higher GERD risk than SGLT-2 inhibitor use (risk ratio [RR], 1.27; 95% confidence interval [CI], 1.14–1.42), corresponding to a risk difference (RD) of 0.7 per 100 patients. The risk of GERD-related complications was also elevated among GLP-1 RA users compared with SGLT-2 inhibitor users (RR, 1.55; 95% CI, 1.12–2.29), with an RD of 0.8 per 1,000 patients.

Source:

Noh Y, et al. (2025, July 15). Ann Intern Med. Glucagon-Like Peptide-1 Receptor Agonists and Risk for Gastroesophageal Reflux Disease in Patients With Type 2 Diabetes: A Population-Based Cohort Study. https://pubmed.ncbi.nlm.nih.gov/40658955/