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Study · Observational study · 2024

6 results

A case for screening real-world data for collateral drug benefits: Glucagon-like peptide 1 receptor agonists and bile acid diarrhea.

Rahbek MT, Lund LC, Hallas J

Pharmacoepidemiology and drug safety9 Aug 2023Cited by 6 (Europe PMC)

PMID37559355 (opens in a new tab)DOI10.1002/pds.5673 (opens in a new tab)PepBankPUB-37559355
Publisher pagePubMedAsk about this study
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Summary

PurposeCollateral drug benefits are hitherto unknown beneficial effects that might lead to repurposing of already marketed drugs. A randomized controlled trial has found liraglutide to be non-inferior to colesevelam in reducing bile acid diarrhea. We hypothesized that this collateral drug benefit of liraglutide could have been detected using observational data.MethodsWe performed a sequence symmetry analysis (SSA). In the SSA, we indexed individuals on the date of the first prescription of GLP1-RA and restricted the analysis to all individuals who had a first prescription of bile acid sequestrants between 365 days prior to until 365 days after the index date. Sequence ratios (SR), that is, the ratio between counts of persons initiating GLP1-RA first versus last, were calculated, and 95% confidence intervals were obtained. We adjusted for prescribing trends using null-effect SR adjustment.ResultsWe included 158 individuals, with a median age of 58 years. The trend-adjusted SR was 0.96 (95% confidence interval 0.70-1.31). When stratifying on the type of GLP1-RA (liraglutide or semaglutide), we found results compatible with the previous trial (SRliraglutide 0.75, 0.51-1.10 and SRsemagltuide 1.23, 0.80-1.89). Since BAS also can be used as a cholesterol lowering drug, we repeated the main analysis while excluded statin users, resulting in a stronger association (SR 0.56, 0.33-0.96).ConclusionUsing the SSA methodology, we obtained estimates of a collateral drug benefit that were compatible with trial results. These results support the use of epidemiological analyses of observational data as instrument for detecting collateral drug benefits.
CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study6

2 results from studies that gave the peptide. 2 results from people.

  1. 01HumanObservational studyEfficacy outcome

    In people starting liraglutide, the sequence ratio for starting bile acid sequestrants was 0.75 (95% CI 0.51-1.10), compatible with the trial.

    In plain wordsIn people starting liraglutide, the data pointed toward less need for bile acid diarrhoea medicine, but the range included no effect.

    Peptide
    Liraglutide
    Outcome
    No significant changeSequence ratio, bile acid sequestrant start after liraglutide
    Study

    n: not reported in source

    Outcome group
    Gastrointestinal protection · Gastrointestinal
    Studied dose
    Dose not stated

    Measurements

    Sequence ratio
    0.75 SR
    liraglutide

    Source sentences

    Summary
    When stratifying on the type of GLP1-RA (liraglutide or semaglutide), we found results compatible with the previous trial (SRliraglutide 0.75, 0.51-1.10 and SRsemagltuide 1.23, 0.80-1.89).
    1 context sentence
    Summary · context
    In the SSA, we indexed individuals on the date of the first prescription of GLP1-RA and restricted the analysis to all individuals who had a first prescription of bile acid sequestrants between 365 days prior to until 365 days after the index date.
  2. 02HumanObservational studyEfficacy outcome

    In people starting semaglutide, the sequence ratio for starting bile acid sequestrants was 1.23 (95% CI 0.80-1.89).

    In plain wordsIn people starting semaglutide, the data showed no clear link with later starting of bile acid diarrhoea medicine.

    Peptide
    Semaglutide
    Outcome
    No significant changeSequence ratio, bile acid sequestrant start after semaglutide
    Study

    n: not reported in source

    Outcome group
    Gastrointestinal protection · Gastrointestinal
    Studied dose
    Dose not stated

    Measurements

    Sequence ratio
    1.23 SR
    semaglutide

    Source sentences

    Summary
    When stratifying on the type of GLP1-RA (liraglutide or semaglutide), we found results compatible with the previous trial (SRliraglutide 0.75, 0.51-1.10 and SRsemagltuide 1.23, 0.80-1.89).
    1 context sentence
    Summary · context
    In the SSA, we indexed individuals on the date of the first prescription of GLP1-RA and restricted the analysis to all individuals who had a first prescription of bile acid sequestrants between 365 days prior to until 365 days after the index date.

Studies that did not test the peptide alone4

In this study, the peptide was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking the peptide.

  1. 03HumanNot a test of Liraglutide aloneObservational studyEfficacy outcome

    In 158 individuals, pooled GLP-1 receptor agonists (liraglutide and semaglutide) showed no association with starting bile acid sequestrants (trend-adjusted SR 0.96).

    In plain wordsIn 158 people, pooled GLP-1 drugs showed no link with later starting of bile acid diarrhoea medicine.

    Peptide
    Liraglutide
    Outcome
    No significant changeTrend-adjusted sequence ratio, bile acid sequestrant start after GLP1-RA (pooled)
    Study

    n = 158

    Outcome group
    Gastrointestinal protection · Gastrointestinal

    Measurements

    Trend-adjusted sequence ratio
    0.96 SR
    all GLP1-RA

    Source sentences

    Summary
    The trend-adjusted SR was 0.96 (95% confidence interval 0.70-1.31).
    1 context sentence
    Summary · context
    In the SSA, we indexed individuals on the date of the first prescription of GLP1-RA and restricted the analysis to all individuals who had a first prescription of bile acid sequestrants between 365 days prior to until 365 days after the index date.

    In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.

  2. 04HumanNot a test of Semaglutide aloneObservational studyEfficacy outcome

    In 158 individuals, pooled GLP-1 receptor agonists (liraglutide and semaglutide) showed no association with starting bile acid sequestrants (trend-adjusted SR 0.96).

    In plain wordsIn 158 people, pooled GLP-1 drugs showed no link with later starting of bile acid diarrhoea medicine.

    Peptide
    Semaglutide
    Outcome
    No significant changeTrend-adjusted sequence ratio, bile acid sequestrant start after GLP1-RA (pooled)
    Study

    n = 158

    Outcome group
    Gastrointestinal protection · Gastrointestinal

    Measurements

    Trend-adjusted sequence ratio
    0.96 SR
    all GLP1-RA

    Source sentences

    Summary
    The trend-adjusted SR was 0.96 (95% confidence interval 0.70-1.31).
    1 context sentence
    Summary · context
    In the SSA, we indexed individuals on the date of the first prescription of GLP1-RA and restricted the analysis to all individuals who had a first prescription of bile acid sequestrants between 365 days prior to until 365 days after the index date.

    In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.

  3. 05HumanNot a test of Liraglutide aloneObservational studyEfficacy outcome

    After excluding statin users, pooled GLP-1 receptor agonists (liraglutide and semaglutide) showed a stronger association with fewer bile acid sequestrant starts (SR 0.56, 0.33-0.96).

    In plain wordsAfter removing statin users, pooled GLP-1 drugs were linked to less starting of bile acid diarrhoea medicine.

    Peptide
    Liraglutide
    Outcome
    DecreaseSequence ratio excluding statin users (pooled GLP1-RA)
    Study

    n: not reported in source

    Outcome group
    Gastrointestinal protection · Gastrointestinal

    Measurements

    Sequence ratio
    0.56 SR
    excluding statin users

    Source sentences

    Summary
    Since BAS also can be used as a cholesterol lowering drug, we repeated the main analysis while excluded statin users, resulting in a stronger association (SR 0.56, 0.33-0.96).
    1 context sentence
    Summary · context
    In the SSA, we indexed individuals on the date of the first prescription of GLP1-RA and restricted the analysis to all individuals who had a first prescription of bile acid sequestrants between 365 days prior to until 365 days after the index date.

    In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.

  4. 06HumanNot a test of Semaglutide aloneObservational studyEfficacy outcome

    After excluding statin users, pooled GLP-1 receptor agonists (liraglutide and semaglutide) showed a stronger association with fewer bile acid sequestrant starts (SR 0.56, 0.33-0.96).

    In plain wordsAfter removing statin users, pooled GLP-1 drugs were linked to less starting of bile acid diarrhoea medicine.

    Peptide
    Semaglutide
    Outcome
    DecreaseSequence ratio excluding statin users (pooled GLP1-RA)
    Study

    n: not reported in source

    Outcome group
    Gastrointestinal protection · Gastrointestinal

    Measurements

    Sequence ratio
    0.56 SR
    excluding statin users

    Source sentences

    Summary
    Since BAS also can be used as a cholesterol lowering drug, we repeated the main analysis while excluded statin users, resulting in a stronger association (SR 0.56, 0.33-0.96).
    1 context sentence
    Summary · context
    In the SSA, we indexed individuals on the date of the first prescription of GLP1-RA and restricted the analysis to all individuals who had a first prescription of bile acid sequestrants between 365 days prior to until 365 days after the index date.

    In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

  1. Version 3Current

    12 Oct 2026, 11:11 UTC

    Study results updated

  2. Version 2

    9 Oct 2026, 03:06 UTC

    Study data updated · source update from Europe PMC

  3. Version 1

    9 Oct 2026, 03:05 UTC

    First added · source update from Europe PMC

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