(891) The Impact of GLP-1 Medications and the Development of Patulous Eustachian Tube Dysfunction

Introduction: Rapid weight loss is known to be associated with the development of patulous eustachian tube dysfunction (PETD). Recently, glucagon-like peptide-1 (GLP-1) receptor agonists were approved for obesity management. We aimed to determine whether GLP-1-based therapies are associated with the development of patulous eustachian tube dysfunction (PETD).

Methods: This is a retrospective database cohort analysis using TriNetX, which aggregates electronic health records from 111 healthcare organizations. 392,953 patients aged ≥18 with an overweight or obese diagnosis (ICD-10-CM: E66) prescribed GLP-1 medication (exenatide, tirzepatide, lixisenatide, semaglutide, liraglutide, or dulaglutide) we identified between 1/1/2022 and 1/1/2025. 3.1 million similar non-GLP-1 users were identified and propensity score matched for demographics, body mass index (BMI), prior PETD diagnosis (ICD-10-CM: H69.0, respectively), and pre-disposing conditions for PETD (e.g. chronic sinusitis, asthma, allergic rhinitis, prior adenoidectomy, and cigarette use). Risk ratios with 95% confidence intervals (95% CI) of subsequent PETD diagnosis and any ETD diagnosis were compared between cohorts.

Results: 390,930 matched GLP-1 users and controls were similar in mean age (50.7 ± 13.9 years vs 51.2 ± 15.6 years), gender (69.7% vs 70.8% female), and BMI range. Median follow-up was similar between cohorts after matching (GLP-1: 725 days [IQR 510] vs. Control: 791 days [IQR 697]). Patients taking GLP-1 therapies had a greater risk of PETD diagnosis (GLP-1 risk 0.027%; Control risk 0.011%; RR 2.55; 95% CI [1.78, 3.64]; p<.001) and any ETD diagnosis (GLP-1 risk 1.84%; Control risk 1.53%; RR 1.20; 95% CI [1.16,1.24]; p<.001), while rates of tympanometry procedures and abnormal weight loss diagnosis were similar in both cohorts.

Conclusions: GLP-1-based treatments were significantly associated with the development of PETD and any ETD. General providers and hearing specialists should be aware of this potential risk when managing patients who take GLP-1-related medications.