Obesity Abstracts

Introduction: In 2024 three patients were admitted to our ICU of whom 2 died with presentations linked to the use of incretin-based therapies for weight loss. In October 2024 we were asked to perform a case review and subsequent audit of all patients with presentations relating to incretin-based therapy use. The initial audit covered a period January 2024 - October 2024. A report was produced and sent to the Chief Medical Officer in Scotland. A safety alert was circulated to all clinicians in our trust in January 2025. A subsequent audit was performed from Nov 2024-Apr 25.

Method: These were retrospective health informatics searches covering Jan-Oct 24, then Nov 2024-Apr 2025 for all patients who attended one of our three EDs in NHS Lanarkshire with any keyword of interest in presenting complaints was conducted. Medication was documented as being counterfeit if had been seen by the authors/there was a description in the notes in keeping with counterfeit medication.

Results: During the first review period 24 patients presented to our 3 Emergency Departments with presentations we deemed related to Incretin therapy use. During the second period there 61 presentations. During both periods the patient group was predominantly female with mean ages of 35.8 years and 37 years respectively. During the first review period there were fewer attendances but a high usage of counterfeit Semaglutide. During the second period, attendances were much higher, counterfeit drug use was rare and the drug being used was predominantly Tirzepatide.

Discussion: Our clinical experience suggests that counterfeit Tirzepatide and newer combination drugs may become more prevalent, particularly following price increases for private Tirzepatide. It is essential that clinicians and the public are made aware of the risks associated with counterfeit medicines and receive appropriate counselling on lifestyle changes to minimise the side effects of prescribed drugs.