Different Effects of Once-weekly and Once-daily Administered GLP-1RA Semaglutide and Liraglutide on Bile Acid Diarrhea

Bile acid diarrhea (BAD) is a socially debilitating disease. Typical symptoms include loose stools, urgency, and high stool frequency. Recently, we reported the superior efficacy of the glucagon like-peptide 1 receptor agonist (GLP-1RA) liraglutide (administered subcutaneously once daily) in reducing daily bowel movements compared with the traditionally used bile acid sequestrant colesevelam (considered the standard of care). This has generated proposals of testing longer acting and more potent GLP-1RAs for treating BAD. Here, we present a patient with severe BAD who experienced minimal effect of the once-weekly administered GLP-1RA semaglutide, but total remission of BAD symptoms during treatment with liraglutide.