Do GLP-1 agonists affect perioperative risk in spine surgery? A systematic review and meta-analysis

作者：Favour C. Ononogbu-Uche, Felix Toussaint, A.W. Saleh, Afnan Hassab E. Siddig, Ramzy Ahmed, Karim Akl, Mostafa H. Algabri, Mohammed Mesfer Alwadai, Lauren Corliss, Norah Foster, Muhammad M. Abd‐El‐Barr · 发表于：North American Spine Society Journal (NASSJ) · 年份：2025 · DOI：10.1016/j.xnsj.2025.100835 · 被引用次数：3 · 研究领域：Cardiac, Anesthesia and Surgical Outcomes、Hyperglycemia and glycemic control in critically ill and hospitalized patients、Enhanced Recovery After Surgery

Background Use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) is increasing among patients presenting for spine surgery, but their perioperative safety and impact on surgical outcomes, particularly pseudoarthrosis, remain uncertain. Methods We conducted a PRISMA-compliant systematic review and meta-analysis (PROSPERO CRD420251111692) of comparative studies enrolling adults undergoing any spine surgery, comparing perioperative GLP-1 RA use with no GLP-1 RA. PubMed, Embase, Web of Science, and EBSCO were searched through August 1, 2025. Two reviewers independently screened, extracted data, and assessed risk of bias with ROBINS-I. Random-effects models were used for dichotomous outcomes, reported as odds ratios (OR) with 95% confidence intervals (CI). Meta-analyses were performed when at least 3 studies reported a given outcome, and outlier studies were excluded from sensitivity analyses. Results Thirteen retrospective cohort studies were included. Across cohorts, baseline characteristics were broadly similar between GLP-1 users ( n = 13,754) and controls ( n = 17,591): weighted mean age approximately 61 years, weighted mean BMI in the low-to-mid 30 s, and high prevalence of type 2 diabetes and hypertension. Seven studies evaluating pseudarthrosis showed much heterogeneity, but there was a lower risk with GLP-1 RA use (OR 0.74; 95% CI: 0.55–1.00; p = .049; I 2 = 91.7%). This finding was heterogeneous but represented sensitivity analysis (OR 0.64; 95% CI: 0.57–0.73; p <...