Otolaryngologic Side Effects of GLP-1 Receptor Agonists

With the increasing use of GLP-1 receptor agonist (GLP-1 RA) drugs for weight loss and diabetes management, concerns have been raised regarding their potential side effects. We aim to assess the frequency of otolaryngologic adverse events (AEs).

Retrospective analysis of national registry.

The Food and Drug Administration's Adverse Event Reporting System (FAERS) database was queried for events related to the GLP-1 RA: exenatide, liraglutide, dulaglutide, semaglutide, and tirzepatide from 1 year after their approval until the end of 2023. AEs were collected and sub-stratified according to anatomic site. Reporting odds ratios (ROR) and proportional reporting ratios (PRR) were determined for all AEs.

The number of AEs reported from all drugs within this study totaled 9,746. Significant signal ratios were defined as a PRR≥2 and a lower CI ROR >1. Medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC) had the highest signals and were significant in virtually all medications. This was followed by GERD which also had very high signal ratios and was significant in all drugs assessed. Semaglutide also had significant signals in anosmia, dry mouth, dysgeusia, and Bell's palsy. Liraglutide had significance in both signals in dysphonia, dysgeusia, tinnitus, and Bell's palsy. This was followed by exenatide which also included dysgeusia and hearing disability.

GLP-1 RA were associated with various otolaryngologic AEs, with significant signals observed for semaglutide and liraglutide. GERD, MTC, and PTC were of significance in all GLP-1 RA in this study. Monitoring these AEs is recommended.

4 Laryngoscope, 135:2291-2298, 2025.