Analysis of Glucagon-Like Peptide Agonist Use in Patients with Transsphenoidal Surgery of the Pituitary Adenoma over Time

Background: The national utilization of glucagon-like peptide agonists (GLP-1) has skyrocketed since Wegovy and Ozempic were FDA approved for weight loss in June of 2021. Literature suggests that these drugs may be associated with an increase in surgical complications. With this in mind, we evaluated the trends of GLP-1 use and the demographics of those receiving them in patients undergoing transsphenoidal surgery (TSS) of the pituitary adenoma to investigate if the use of these drugs changed in this population after FDA approval.

Materials and Methods: Utilizing TriNetX, a large multicenter database, we analyzed the profiles of over 166 million patients within the United States (US). A cohort of patients with TSS (CT: 62165) on GLP-1 agonists (ATC: A10BJ) between the years 2015 and 2023 was created to evaluate geographical distribution and demographic trends. Individual cohorts were made for each year between 2015 and 2023 of patients with TSS to evaluate GLP-1 use over this period. A t-test was used to determine if a statistically significant difference in number of patients on GLP-1 existed between the 2015 cohort and 2023 cohort.

Results: We identified a total of 654 patients from 2015 to 2023 with TSS who were on GLP-1 agonists. Of these patients, 64.8% were female, 32.5% were male, 62.2% were white, 19% were African American, and 2.3% were Asian ([Table 1]). The geographic distribution of patients consisted of 49% residing in the South, 24% in the Northeast, 19% in the Midwest, and 8% in the West ([Table 1]). The total number of patients with TSS increased from 464 patients in 2015 to 1,087 patients in 2023 ([Table 2]). However, the percentage of patients on GLP-1 agonists decreased overall from 2015 (8.19%) to 2023 (6.16%), though this was not statistically significant (p = 0.07). The peak percentage of use was 9.10% in 2020 ([Table 2]).

Conclusion: Patients with TSS with GLP-1 use were majority female, white, and resided in the South of the United States (49%). Overall, utilization of GLP-1 agonists decreased from 2015–2023, despite FDA approval of Wegovy and Ozempic for weight loss in 2021. Further studies may investigate trends of GLP-1 use in patients who underwent TSS with a larger sample size or evaluate the effects of GLP-1 on a patient’s post-surgical outcomes.

Publication History

Article published online:
07 February 2025