Assessing the Impact of GLP-1R Agonists in Post-sinus Surgery Management.

Abstract

Emerging evidence suggests a potential association between chronic rhinosinusitis (CRS) and obesity. With the increasing utilization of weight loss medications in the management of obesity, we aimed to assess the impact of glucagon-like peptide-1 receptor agonist (GLP-1RA) prescription on the revision rate of functional endoscopic sinus surgery (FESS) and the use of biologics post-FESS. Retrospective cohort analysis. US Collaborative Network within the TriNetX Analytics platform. We queried the TriNetX Analytics platform for all adult CRS with nasal polyps (CRSwNP) patients with obesity who have undergone at least one prior FESS (based on Current Procedural Terminology [CPT] code). The incidence of revision surgery and first-time biologic prescriptions (dupilumab, mepolizumab, and omalizumab) within a 1- and 5-year follow-up period was assessed, comparing those with and without GLP-1R agonist prescriptions. After 1:1 propensity matching, there were a total of 1391 patients in each patient group. The GLP-1RA cohort had a significantly reduced incidence of revision FESS compared to the non-GLP-1RA cohort at 1-year (RR: 0.64; 95% CI: 0.41-0.98, P = .04) and 5-year follow-up periods (risk ratio [RR]: 0.60; 95% CI: 0.44-0.0.81, P = .001). At the 5-year follow-up, the first-time biologic prescription was lower in the GLP-1RA cohort compared to the non-GLP-1RA cohort (RR: 0.72; 95% CI: 0.52-0.98, P = .04). Our results indicate that GLP-1RAs are associated with reduced postoperative revision FESS at up to a 5-year follow-up in CRSwNP patients. Future mechanistic and prospective studies are needed to confirm the association between GLP-1R agonists and improved post-sinus surgery outcomes identified in this study.