Study: Weight-loss drug semaglutide boosts repeat surgery risk

Editor's Note

Popular weight-loss \ drug semaglutide could significantly increase risk for repeat operations patients with diabetes who undergo lumbar surgery. According to a May 8 report in Medscape Medical News, the findings are pending review for publication and reportedly provides the first evidence on the impact of semaglutide on spine surgery.

Although researchers cannot conclude that  glucagon-like peptide 1 (GLP-1) receptor agonists besides semaglutide present similar risks, “the odds of a class effect are high,” investigator Syed I. Khalid, MD, neurosurgery resident at University of Illinois Chicago, told Medscape Medical News. As for the reason for repeat operations, “it could be the fact there is sarcopenia or muscle loss that's taking place in conjunction with fat loss that's causing that to happen," he said, identifying this as a topic for follow-up study.

According to the report, the study compared 447 patients with semaglutide use and 1334 with no semaglutide use. Total medical complications were higher among the 447 patients in the semaglutide group, at 13.4%, compared with 7.7% of the 1,334 patients in the no-semaglutide group (odds ratio [OR], 1.85). This was driven by higher rates of urinary tract infection (6.7% vs 2.5%) and acute kidney injury (6.3% vs 3.9%).

However, total surgical complications, were lower among patients taking semaglutide, at 3.8% vs 5.2% in those who did not (OR, 0.73). These patients also had fewer wound healing complications (5 vs 31), hematoma (1 vs 9), surgical-site infections (12 vs 44), and cerebrospinal fluid leaks (2 vs 3), Medscape reports. However, people taking semaglutide were nearly 12 times more likely to have an additional lumbar surgery at 1 year than did those who did not use the drug (27.3% vs 3.1%; OR, 11.79; 95% CI, 8.17-17.33). The risk for repeat procedures was higher among patients taking the drug for longer periods of time.