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Glucagon-like Peptide-1 Receptor Agonists and Carpal Tunnel Syndrome
Travis Kotzur, BS
1; Aaron Singh, B.A.
1; Blaire Peterson, BS
1; Lindsey Peng, BS
1; Jordan Carter, MD
1; Ryan Rose, MD
1; Christina Brady, MD
21UT Health San Antonio, San Antonio, TX; 2Audie L. Murphy Memorial Veterans' Hospital, San Antonio, TX
Introduction: Glucagon-like Peptide-1 receptor agonists (GLP-1) are a relatively novel and increasingly population drug class for diabetes and obesity - well known risk factors for carpal tunnel syndrome (CTS). This study aims to assess the impact of GLP-1 medications on the development of CTS requiring treatment and subsequent need for revision surgery.
Methods: This retrospective matched cohort study utilized the TriNetX platform, years 2009 through 2024. Patients receiving GLP-1s with CTS were matched to a control cohort not receiving these medications. The risk for requiring corticosteroid injection or surgery for CTS within three years of index was compared between cohorts. Secondarily, subanalysis among patients who underwent operative management was conducted to compare the risk of requiring repeat carpal tunnel release between the GLP-1 cohort and control.
Results: A total of 38,956 patients diagnosed with CTS were matched. The GLP-1 cohort was more likely to receive corticosteroid injection (OR 1.17 (95% 1.10, 1.24) p<0.001) and operative management (OR 1.15 (95% 1.12, 1.19) p<0.001). Subanalysis of a matched cohort of 6,977 patients undergoing operative management demonstrated reduced odds of repeat carpal tunnel release (OR 0.91 (95% 0.85, 0.98) p=0.008).
Conclusion: Patients receiving GLP-1s had greater risk of requirement intervention - both with corticosteroid injection and surgery - compared to a matched cohort. However, they had an improved postoperative course, with less need for revision surgery. Further research is required to elucidate the relationships and mechanisms between GLP-1s and these outcomes.
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