Poster 6: GLP-1 Receptor Agonist Use Is Not Associated With an Increased Risk of Complications After Anatomic Total Shoulder Arthroplasty

Objectives: Glucagon-like-peptide-1 (GLP-1) agonists, also known as GLP-1 receptor agonists (GLP-1 RAs), incretin mimetics, or GLP-1 analogs are a class of medications that have surged in popularity since their approval. Originally developed and indicated for the treatment of type 2 diabetes mellitus, GLP-1 RAs have now also been approved for the treatment of obesity, with more uses currently under investigation. Thus, GLP-1 RA use is only expected to increase. Despite this, little research has been done to assess the possible adverse effects of GLP-1 RA use, especially on surgical complications. In this study, we queried the TriNetX database to investigate the effects of GLP-1 RA therapy on the incidence of several 90-day surgical complications in total shoulder arthroplasty (TSA) patients. Methods: The TriNetX research network was queried to identify all patients undergoing primary anatomic TSA between May 2005 and July 2024 across 66 healthcare organizations. Patients were then sorted into two different cohorts based on preoperative GLP-1 use. Propensity score matching was performed to account for prior differences in demographics, lab values, and comorbidities. Data analysis and risk calculations for the selected 90-day complications were performed using TriNetX’s built-in analysis platform. Results: A total of 59,180 patients underwent TSA, with 1,489 of them using GLP-1 RAs pre-operatively. After propensity score matching, there were 1390 patients in the GLP-1 and no GLP-1 cohorts undergoing TSA. Subsequently, we found no statistically significant differences in the risk of various 90-day complications after TSA between those who used GLP-1 RAs and those who did not. These included readmission, ED utilization, revision surgery, superficial surgical site infection, infection of prosthesis, deep vein thrombosis, pulmonary embolism, acute renal failure, aspiration, and mortality. Conclusions: GLP-1 RA use preoperatively was not associated with any statistically significant change in the risk of complications within 90 days of undergoing TSA. Patients taking GLP-1 RAs experienced similar risks of all examined complications as those who were not prescribed GLP-1 RAs. Thus, our results indicate that GLP-1 RAs are likely safe for patient use prior to TSA and do not increase the risk of 90-day complications described in this study.