Introduction: Although glucagon-like peptide-1 receptor agonists (GLP-1 RAs) demonstrate remarkable efficacy for weight management, emerging pharmacovigilance data suggest an increased hair loss risk, particularly with newer agents. This study investigated the prevalence, risk factors, and clinical impact of hair shedding in GLP-1 RA users in Saudi Arabia. Methods: A cross-sectional survey was conducted among GLP-1 RA users. Hair shedding prevalence, associated factors, and the impact on treatment discontinuation were assessed using validated questionnaires. Results: Among 152 eligible participants, 70.4% reported hair shedding after GLP-1 RA initiation, which was markedly higher than the 3-7% reported in clinical trials. Hair shedding was significantly associated with female sex and greater magnitude of weight loss. Multivariable analysis confirmed independent associations with increasing weight loss (OR 1.79, 95% CI 1.19-2.76, p=0.006) and female sex (OR 3.57, 95% CI 1.20-11.11, p=0.023). Critically, 39.7% of the affected patients cited hair shedding as their reason for discontinuation, although 37.7% reported resolution after stopping treatment. Conclusion: Hair shedding affects seven out of ten GLP-1 RA users in real-world settings, representing a ten-fold higher prevalence than that reported in registration trials. This under-recognized phenomenon significantly affects treatment adherence, particularly among women who achieve substantial weight loss.
Alharbi et al. (Mon,) studied this question.