A potentially serious adverse effect of GLP-1 receptor agonists

To the Editor: Glucagon-like peptide-1(GLP-1)is a small intestine-derived hormoner,2.Its peptidic analogs include exenatide,lixisenatide,dulaglutide,liraglutide,albiglutide,semaglutide,etc.They work as GLP-1 receptor agonists(GLP-1 RAs)to treat type 2 diabetes,obesity,hypertension and dyslipidemia.Among them,semaglutide with once-daily oral dosage form(brand name:Rybelsus?)and once-weekly subcutaneous injectable formulation(brand names:Ozempic? and Wegovy?)have shown a superiority in weight management with expected annual sales beyond $10 billion3.While their efficacies and safety profiles are widely accepted,long-term adverse events such as increased risk of intestinal obstruction have been reported in diabetic patients,which is 4.5 times higher than those receiving other glucose control medica-tions4.A real-world study of 25,617 subjects demonstrated a 3.5-fold increase in the intestinal obstruction rate associated with GLP-1RA treatment5.