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Video

Otology/Neurotology

(A816) Eustachian Tube Disorders in Patients Prescribed Glucagon-like Peptide-1 (GLP-1) Agonists: A Propensity Score Matching Analysis

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Kaitlin H. Hori, BS

    Medical Student
    University of Southern California
    Los Angeles, CA, United States

    • Senior Author(s)

  • Janet S. Choi, MD, MPH

    Assistant Professor
    Caruso Department of Otolaryngology-Head and Neck Surgery
    Los Angeles, California, United States

Disclosure(s):
Kaitlin H. Hori, BS: No relevant relationships to disclose.
Janet S. Choi, MD, MPH: No relevant relationships to disclose.


Introduction: Glucagon-like Peptide-1 (GLP-1) agonists stimulate glucose-dependent insulin release and are commonly used to manage diabetes mellitus, with significant associations to weight loss. This study investigated the incidence and risks of eustachian tube disorders including patulous eustachian tube associated with GLP-1 agonist use.

Methods: Using the TriNetX multi-institutional research database, we identified US adults (≥18 years) with diabetes mellitus by ICD-10 code who were prescribed and not prescribed a GLP-1 agonists. The two groups were matched via propensity scores based on demographics and comorbidities. Analyses included all GLP-1 agonists combined and individual agents (Dulaglutide, Exenatide, Liraglutide, Lixisenatide, Semaglutide, Tirzepatide). Outcomes for patulous eustachian tube and eustachian tube disorders were identified by ICD-10 code, and risk ratios (RR) were calculated using Poisson regression.

Results: The cohort included 1,026,306 diabetes patients who used a GLP-1 agonist, and 9,168,174 patients who did not. After propensity score matching, each cohort included 994,337 patients. The incidence of patulous eustachian tube was 0.012% in GLP-1 users and 0.011% in non-users. Overall, any GLP-1 agonist use in diabetes patients was not associated with increased risk of patulous eustachian tube (RR 1.09; 95% CI 0.84-1.42) or eustachian tube disorders (RR 1.002; 95% CI 0.98-1.03). However, Liraglutide administered daily (vs. Semaglutide administered weekly) was linked to increased risks of both patulous eustachian tube (RR 2.33; 95% CI 1.34-4.05) and eustachian tube disorders (RR 1.63; 95% CI 1.55-1.71). Exenatide demonstrated an increased risk of eustachian tube disorders (RR 2.02; 95% CI 1.87-2.18), while Semaglutide was associated with a reduced risk of eustachian tube disorders (RR 0.72; 95% CI 0.70-0.75).

Conclusions: Different GLP-1 agonists were associated with varying risks for eustachian tube disorders. A history of GLP-1 agonist use, including the specific agent, should be considered when patients present with symptoms related to the eustachian tube.