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Patients on GLP-1 RA Therapy Who Undergo Carpal and Cubital Tunnel Release Have Significantly Less Comorbidities
Kristi T Nguyen, B.S.
1; Apurva Choubey, M.D.
1; Nirav K Mungalpara, M.D.
1; Brett Drake, B.S.
1; Salma Mumuni, M.D.
1; Alfonso Mejia, MD
2; Mark Gonzalez, MD, PhD
31University of Illinois at Chicago, Chicago, IL; 2Orthopaedic Surgery, University of Illinois at Chicago, Chicago, IL; 3University of Illinois at Chicago, Department of Orthopaedic Surgery, Chicago, IL
Introduction:Glucagon-like Peptide-1 Receptor Agonists (GLP-1 RAs) are an emerging group of medications effective in treating diabetes and obesity. However, their effects on orthopedic patients are not well-researched. Early data suggest that patients on GLP-1 RA therapy experience fewer complications and better outcomes following surgery, likely due to the medication's effects on reducing adiposity, managing blood glucose, and promoting anti-inflammatory responses. Understanding these effects could inform pre- and post-operative care for orthopedic patients undergoing surgical procedures. This study investigates the impact of GLP-1 RA therapy on patients undergoing carpal tunnel release (CTR) and cubital tunnel release (CuTR).
Methods:Using the Pearl Diver Mariner 165 claims database, a 10:1 matched analysis was performed for 139,780 patients who underwent CTR and 21,045 patients who underwent CuTR. These patients were identified using the current procedural terminology (CPT) codes 64721 and 29848 for CTR, and 64718 for CuTR. Patients not receiving GLP-1 RA therapy (control) and those receiving GLP-1 RA therapy (variable) were matched for age, gender, Elixhauser Comorbidity Index (ECI), diabetes, obesity, and hypertension (HTN). Two-sample T-tests and Pearson's Chi-square tests were used to compare the control and variable groups.
Results:After matching, 139,780 CTR and 21,045 CuTR patients were identified between 2010 and 2022. The control group exhibited a higher likelihood of diagnoses of depression (OR 1.23, p < 0.001), autoimmune disease (OR 1.21, p < 0.001), fluid and electrolyte disorders (OR 1.16, p < 0.001), and cervical radiculopathy (OR 1.10, p < 0.001). The control group was also 1.32 times more likely to have 90-day ED visits. Similar outcomes were observed in the CuTR cohort. In the CuTR control group, there was a higher likelihood of depression (OR 1.21, p < 0.001) and autoimmune disease (OR 1.35, p < 0.001) diagnoses. The CuTR control group was also 1.31 times more likely to have 90-day ED visits.
Conclusion:This study provides important insights into the effects of GLP-1 RA therapy on patients undergoing CTR and CuTR. Our findings highlight significant associations between GLP-1 RA treatment and reduced comorbidities. These outcomes suggest that CTR and CuTR patients on GLP-1 RA therapy have fewer comorbidities, potentially leading to better surgical outcomes.
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