by Elana Gotkine

Greater reduction seen in mortality with bariatric surgery than GLP-1 RAs


Bariatric metabolic surgery (BMS) is associated with a greater reduction in mortality than glucagon-like peptide-1 receptor agonist (GLP-1 RA) treatment among adults with a diabetes duration of 10 years or less, according to a study published online June 7 in JAMA Network Open.

Dror Dicker, M.D., from Rabin Medical Center in Petah Tikva, Israel, and colleagues compared all-cause mortality and nonfatal major adverse cardiovascular events associated with BMS versus GLP-1 RAs for adults with obesity and diabetes and without known cardiovascular disease in an observational retrospective cohort study. Data were included for 6,070 participants, aged 24 years or older. The study included 3,035 matched pairs of patients who underwent BMS or received GLP-1 RAs, followed for a median of 6.8 years.

The researchers found that mortality was lower for those who underwent BMS versus those who received GLP-1 RA treatment (hazard ratio, 0.38) among the 2,371 pairs of patients with a diabetes duration of 10 years or less. When weight loss during the follow-up period was also included in the model, the association became nonsignificant.

No survival advantage was demonstrated for BMS over GLP-1 RAs among 664 patients with a duration of diabetes longer than 10 years. There was no significant difference noted between the groups in the risk for nonfatal major adverse cardiovascular events.

"The survival advantage associated with BMS compared with treatment with GLP-1 RAs may be explained by the greater relative decrease in body mass index observed among patients who underwent BMS (−31.4%) compared with that achieved among patients treated with GLP-1 RAs (−12.8%)," the authors write.

One author disclosed ties to Novo Nordisk, Eli Lilly, and Boehringer Ingelheim.

More information: Dror Dicker et al, Bariatric Metabolic Surgery vs Glucagon-Like Peptide-1 Receptor Agonists and Mortality, JAMA Network Open (2024). DOI: 10.1001/jamanetworkopen.2024.15392

Journal information: JAMA Network Open 

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