(1233) GLP-1 Receptor Agonist Use and CRS Outcomes After Sinus Surgery in T2D, Obesity, and OSA

Introduction: Obesity, type 2 diabetes (T2D), and obstructive sleep apnea (OSA) are associated with an increased inflammatory burden and are established risk factors for chronic rhinosinusitis (CRS). In obese patients, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been linked to reduced nasal polyposis recurrence and decreased functional endoscopic sinus surgery (FESS) for CRS, supporting their role in reducing inflammation. However, their effect on CRS outcomes post-FESS, particularly in T2D, is unclear. Therefore, this study evaluated post-FESS outcomes in CRS patients with obesity, T2D, and OSA.

Methods: Using TriNetX, patients with obesity, T2D, or OSA who underwent FESS were identified and stratified by post-FESS GLP-1 RA use. CRS recurrence, defined by repeat FESS, and severity, defined by antibiotic and oral steroid use, were assessed at least 3 months after first FESS and compared between GLP-1 RA users and non-users.

Results: After propensity matching, there were 2,290 T2D, 2,448 obesity, and 2,065 OSA patients in each cohort. GLP-1 RA use was associated with reduced CRS recurrence (RR < 0.64, p< 0.03 in all groups) and increased use of antibiotics (RR>1.15, p< 0.0003 in all groups) and oral steroids (RR>1.14, p< 0.004 in all groups).

Conclusions: GLP-1 RA use is associated with lower CRS recurrence but increased post-FESS antibiotic and oral steroid use in patients with T2D, obesity, and OSA. This may reflect a shift toward medical management with improved metabolic control rather than increased disease severity. Further studies are needed to confirm these findings, explore mechanisms, and assess postoperative decision-making.