Author(s)
Rishi Katragadd, BS1
Daniel Karasik, MD2
Sanjeet Rangarajan, MD, FACS2
Kenneth Rodriguez, MD, FACS2
Jennifer Villwock, MD, FACS2
Brian D'Anza, MD, FACS2
Affiliation(s)
1Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
2Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
Abstract:
Background: Glucagon-like peptide-1 receptor agonists (GLP-1s) are widely used for treating obesity and metabolic disease due to their weight-loss and anti-inflammatory effects. Obesity related inflammation is linked to higher chronic rhinosinusitis (CRS) prevalence and symptom burden. We evaluated whether GLP-1 use in obese adults with CRS was associated with lower treatment utilization, used as a proxy for disease burden, compared with matched non-users.
Methods: Using TriNetX EHR data, we identified adults with CRS and obesity (BMI >30) who started a GLP-1 after CRS and obesity diagnoses and compared them with non-users. Patients with prior FESS were excluded. Outcomes at 1, 3, and 5 years included use of intranasal steroids (INCS), oral steroids, antibiotics, biologics, and any therapy. Cohorts were propensity score matched by demographics, BMI, and comorbidities.
Results: At 1 year, GLP-1 users had lower use of antibiotics (OR 0.86 [0.83-0.89], p<.001), oral steroids (OR 0.76 [0.73-0.78], p<.001), INCS (OR 0.83 [0.78-0.88], p<.001), and any therapy (OR 0.78 [0.75-0.79], p<.001); however higher biologic use was higher (OR 1.61 [1.39-1.89], p<.001). At 3 years, this trend continued with lower use of antibiotics (OR 0.78), oral steroids (OR 0.65), INCS (OR 0.81), and any therapy (OR 0.67), while biologic use remained elevated (OR 1.27). At 5 years, GLP-1 users had lower utilization of non-biologic therapies, while biologic use no longer differed between cohorts (OR 1.06 [0.94-1.19], p=.343).
Conclusion: In obese adults with CRS, GLP-1 use was linked to reduced reliance on several non-biologic therapies and higher biologic use. These findings suggest GLP-1 therapy may reduce treatment burden in CRS.