Prior GLP-1 Receptor Agonist Use Does Not Worsen ICU Outcomes, Reports Research
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USA: A new study published in the Journal of Hospital Medicine, analyzing nearly 25,000 ICU admissions over nine years, found that prior use of GLP-1 receptor agonists was not associated with worse outcomes in critically ill patients. There were no significant differences in mortality or ICU length of stay between patients who had used GLP-1 drugs and those who had not, suggesting these agents do not adversely affect ICU outcomes.
GLP-1 receptor agonists are increasingly used to treat type 2 diabetes and obesity and are known to alter body composition, primarily by reducing fat mass. Given the severe metabolic stress and muscle loss seen in critically ill patients, concerns have been raised about whether prior GLP-1 use could worsen ICU outcomes.
To address this, Albert K. Park, MD, of Stanford University Medical Center, and colleagues conducted a retrospective cohort study using Stanford Health Care data from ICU admissions between January 2015 and July 2024. The analysis included adults aged 18–89 years with a body mass index of 20–60 kg/m².
Among 15,191 eligible ICU patients, 468 (3.1%) had used a GLP-1 receptor agonist within 12 months before hospitalization. Using high-dimensional propensity score matching with lasso regression, the researchers created 452 matched patient pairs with well-balanced baseline characteristics, enabling a robust comparison between patients with and without prior GLP-1 agonist exposure.
The study revealed the following notable findings:
- In-hospital mortality rates were similar between patients with prior GLP-1 agonist use and those without, with no statistically significant increase in risk.
- Total hospital length of stay did not differ meaningfully between the two groups.
- ICU length of stay was also comparable, indicating that prior GLP-1 agonist use did not prolong critical care requirements or recovery.
These findings are particularly relevant given the growing number of patients admitted to the ICU who are receiving GLP-1 receptor agonists before hospitalization. Clinicians have raised questions about whether appetite suppression, weight loss, or changes in muscle mass associated with these agents could worsen outcomes during periods of severe illness. The current study provides reassuring evidence that such concerns may be unfounded, at least in terms of short-term inpatient and ICU outcomes.
The authors note that this is the first study to specifically examine the relationship between prior GLP-1 agonist use and critical care outcomes using a robust, propensity-matched design. While the analysis focused on mortality and length of stay, it did not assess longer-term functional outcomes, such as post-ICU weakness or recovery of muscle strength, which may warrant further investigation.
"The study suggests that prior treatment with GLP-1 receptor agonists does not adversely impact mortality or length of stay among critically ill patients. As the use of these medications continues to expand, the findings offer important reassurance to clinicians managing patients who require intensive care while receiving or having recently used GLP-1–based therapies," the authors concluded.
Reference:
Park, A. K., Hom, J., Lorenzo, J., Rao, V., Hui, G., Vickers, M., & Ahuja, N. Prior GLP-1 agonist use is not associated with adverse inpatient critical care outcomes: A propensity-matched analysis. Journal of Hospital Medicine. https://doi.org/10.1002/jhm.70228
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