Pharmacomicrobiomics of GLP-1 receptor agonist gastrointestinal tolerability: integrating host genetics and the gut microbiome.
Gastrointestinal (GI) adverse events, such as nausea, vomiting, diarrhea, and constipation, remain a dominant barrier to the sustained use of GLP-1 receptor agonists (GLP-1 RAs), driving discontinuation independently of the drug’s metabolic benefits. Two host-side biological systems have been independently established as determinants of this variability. The first is host genetics, anchored by a 2026 genome-wide association study in which GLP1R variants predicted both weight-loss efficacy and na...