Subsequent case reports have documented similar concerning events, including the Gulak and Murphy series describing a 70-year-old male who regurgitated large-volume particulate contents during laryngoscopy two days after semaglutide cessation [5]
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Originally approved for type 2 diabetes and later for obesity treatment, GLP-1 and other incretin-based therapies have rapidly gained traction in both clinical and consumer spaces
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The main enzyme involved, dipeptidyl peptidase-4 (DPP-4) also known as CD26, cleaves off the two N-terminal residues resulting in GLP-1 (9-36 amide) which is inactive or acts as an inhibitor at the GLP-1 receptor (23)