AUTHOR=Chen Jie-Hai , Chen Jia-Cong , Mei Ya-Jing , Zhu Xiao-Chun , Luo Qing-Ming , Tu Yuan-Yan 
  
TITLE=Risk factors for drug-related impaired gastric emptying: a pharmacovigilance analysis of the FDA adverse event reporting system
  
JOURNAL=Frontiers in Pharmacology
  
VOLUME=Volume 17 - 2026
  
YEAR=2026
  
URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2026.1844057
  
DOI=10.3389/fphar.2026.1844057
  
ISSN=1663-9812
  
ABSTRACT=BackgroundPulmonary aspiration remains a major perioperative patient safety issue. Drug-related impaired gastric emptying (IGE) is a recognized yet underappreciated risk factor for aspiration. With the increasing use of medications such as glucagon-like peptide-1 receptor agonists (GLP-1RAs), concerns have grown regarding their potential to delay gastric emptying and thereby elevate aspiration risk. However, real-world data on drug-related IGE remain limited.ObjectiveTo identify risk factors for drug-related IGE using real-world pharmacovigilance data from the FDA Adverse Event Reporting System (FAERS).MethodsA retrospective pharmacovigilance study was conducted using FAERS data from Q1 2004 through Q2 2025. Disproportionality analysis, logistic regression, LASSO regression and time-to-onset analysis were performed to investigate the association between drugs and IGE from different perspectives.ResultsA total of 731 drugs related to IGE. Six of the top 10 most frequently reported drugs associated with IGE were antidiabetic agents, including five GLP-1RAs: semaglutide, dulaglutide, tirzepatide, exenatide, and liraglutide. Multi-factor analysis identified female sex, age <63 years, and exposure to any of nine specific drugs—including GLP-1RAs, insulin lispro, sodium oxybate, olmesartan, and esomeprazole—as independent risk factors for drug-related IGE. The model achieved an ROC-AUC of 0.739, indicating good discriminatory capability. Time-to-onset analysis revealed an early-failure pattern for all nine drugs.ConclusionOur study shows that female sex, younger age, and use of specific medications are associated with an increased risk of drug-related IGE. These findings may provide valuable evidence to support the early recognition of drug-related IGE and for optimizing anaesthetic plans and perioperative personalized fasting strategies.