A new study published in Otolaryngology–Head and Neck Surgery suggests that glucagon-like peptide-1 receptor agonists (GLP-1RAs)—commonly prescribed for diabetes and weight management—may significantly improve post-surgical outcomes for patients with chronic rhinosinusitis with nasal polyps (CRSwNP) who also have obesity.
The retrospective cohort study analyzed data from 1,391 matched pairs of adult patients with CRSwNP, obesity, and at least one prior functional endoscopic sinus surgery (FESS). Results showed that patients taking GLP-1RAs experienced a 36% reduction in the need for revision sinus surgery at one year. Long-term follow-up revealed a 40% decrease in revision surgeries and a 28% reduction in first-time biologic prescriptions five years after surgery.
“Using real-world electronic health record data, our study found that patients with chronic rhinosinusitis with nasal polyps and obesity who were treated with GLP-1 receptor agonists had lower rates of revision sinus surgery and reduced need for additional therapies, including biologics, over a five-year period,” said Mohamad R. Chaaban, MD, MSCR, MBA, corresponding author and member of the Cleveland Clinic Head and Neck Institute. “As a retrospective study, these findings are observational, highlighting the need for future prospective research to clarify causality and underlying mechanisms.”
Researchers leveraged the TriNetX Analytics platform, which aggregates data from over 100 million patient records across 59 U.S. healthcare organizations. They compared outcomes of patients who received GLP-1RA prescriptions—such as semaglutide, dulaglutide, and liraglutide—at least one day after sinus surgery with those who did not receive these medications.
The potential mechanisms behind the observed improvements may be twofold. GLP-1RAs have documented anti-inflammatory effects in airway tissues, including reduced interleukin-33 (IL-33) production in nasal epithelial cells—a protein linked to postoperative recurrence of nasal polyps. Additionally, weight loss resulting from GLP-1RA therapy may reduce the inflammatory burden associated with obesity, a recognized risk factor for chronic rhinosinusitis.
With obesity rates continuing to rise in the United States and chronic rhinosinusitis affecting millions of Americans, these findings could have significant implications for the management of both conditions. However, the authors emphasize that prospective studies and mechanistic research are needed to confirm these associations and fully understand how GLP-1RAs impact chronic sinus disease outcomes.
