Improved total shoulder arthroplasty outcomes associated with semaglutide utilization in patients with type II diabetes: a promising new addition to preoperative optimization

Q2 Medicine

JSES International Pub Date : 2025-05-01 DOI:10.1016/j.jseint.2024.10.006

Anthony E. Seddio BS, Christopher V. Wilhelm MD, Michael J. Gouzoulis BS, Wasif Islam MD, Rajiv S. Vasudevan MD, Scott J. Halperin MD, Lee E. Rubin MD, Michael J. Medvecky MD, Kenneth W. Donohue MD, Jonathan N. Grauer MD

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Abstract

Background

Semaglutide (the active agent in Ozempic [Novo Nordisk, Plainsboro, NJ, USA]) has been increasingly recognized as one of the most effective medications in the management of type II diabetes mellitus (T2DM). Patients with T2DM undergoing orthopedic surgery, such as total shoulder arthroplasty (TSA), may be using this medication for management of their disease. While T2DM has been associated with inferior postoperative TSA outcomes, the correlation of preoperative semaglutide use on such outcomes has never been characterized.

Methods

T2DM patients undergoing TSA (anatomic or reverse) were identified from the PearlDiver M165Ortho database using administrative coding. T2DM patients who utilized semaglutide within 1 year before TSA were identified and matched 1:4 with T2DM patients who did not based on age, sex, Elixhauser Comorbidity Index, end-organ diabetes complications, body mass index, tobacco, insulin, and metformin use. Incidence of 90-day adverse events were compared by univariable and multivariable analyses.

Results

After matching, there were 632 T2DM +semaglutide and 2302 T2DM −semaglutide patients. On multivariable analysis of the matched populations, T2DM +semaglutide patients had significantly lower odds of surgical site infection (odds ratio (OR) 0.25, P = .003), cardiac events (OR 0.32, P = .003), venous thromboembolism (OR 0.36, P = .001), pneumonia (OR 0.25, P < .001), urinary tract infection (OR 0.30, P < .001), acute kidney injury (OR 0.39, P < .001), and emergency department visit (OR 0.37, P < .001).

Conclusion

The current study encouragingly found reductions in 90-day adverse outcomes following TSA for patients with T2DM using semaglutide preoperatively. Further prospective analysis is warranted as the observed findings suggest clinical benefit of semaglutide integration into preoperative optimization pathways by the studied patient population.

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改善全肩关节置换术结果与2型糖尿病患者使用西马鲁肽相关：一个有希望的术前优化的新补充

背景：semaglutide （Ozempic的活性药物[Novo Nordisk， Plainsboro， NJ, USA]）被越来越多地认为是治疗2型糖尿病（T2DM）最有效的药物之一。2型糖尿病患者接受骨科手术，如全肩关节置换术（TSA），可能会使用这种药物来治疗他们的疾病。虽然T2DM与较差的术后TSA结果相关，但术前使用西马鲁肽与这些结果的相关性从未被描述过。方法采用行政编码从PearlDiver M165Ortho数据库中识别接受TSA（解剖或反向）的st2dm患者。根据年龄、性别、Elixhauser合并症指数、终末器官糖尿病并发症、体重指数、烟草、胰岛素和二甲双胍使用情况，确定TSA前1年内使用西马鲁肽的T2DM患者与未使用西马鲁肽的T2DM患者进行1:4匹配。采用单变量和多变量分析比较90天不良事件发生率。结果配对后，T2DM +组632例，T2DM -组2302例。在匹配人群的多变量分析中，T2DM +semaglutide患者手术部位感染（比值比（OR） 0.25, P = 0.003）、心脏事件（OR 0.32, P = 0.003）、静脉血栓栓塞（OR 0.36, P = 0.001）、肺炎(OR 0.25, P <；.001)、尿路感染(OR 0.30, P <；.001)，急性肾损伤(OR 0.39, P <；.001)和急诊就诊(OR 0.37, P <；措施)。目前的研究令人鼓舞地发现，T2DM患者术前使用西马鲁肽进行TSA后90天不良后果的减少。进一步的前瞻性分析是有必要的，因为观察到的结果表明，在被研究的患者群体中，将西马鲁肽纳入术前优化途径的临床益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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