Prehospital glucagon-like peptide-1 receptor agonists are not associated with reduced inpatient opioid exposure but with shorter hospital length of stay after total joint arthroplasty
- Design
- Retrospective cohort · 882 participants · Hard outcome
- Match to healthy normal-weight adults aged 55–75
- Population unclear[Auto] Population characteristics not extractable from abstract (age/BMI not reported in abstract). Needs manual review.
- Could weight loss explain it?
- Unknown[Auto] Not addressed in abstract.
- Study tier
- Study tier 3[Auto] Observational design; confounding by indication and healthy-user effects cannot be excluded (auto-provisional).
- Assessment
- Version 1 · automatic, not yet reviewed by a person · Sep 13, 2026
Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75.
[Auto, unreviewed; quoted from abstract conclusions] Chronic preoperative GLP-1RA therapy was not associated with reduced inpatient opioid exposure or improved early postoperative pain control following TJA. Nevertheless, GLP-1RA use was consistently associated with shorter hospital LOS. Prospective studies are needed to determine whether this finding reflects improved recovery pathways or residual confounding and to evaluate the impact of GLP-1RAs on longer-term postoperative outcomes and opioid utilization.
01Findings
What the study reported
- Drugs
- Class unspecified
- Primary outcome
- Not extracted
- Effect
- Not extracted
- 95% confidence interval
- Not extracted
- Follow-up
- Not stated
- Adverse events
- Not extracted
- Limitations
- Auto-classified from abstract only; effect estimates, adverse events and limitations not extracted. Requires manual review.
Who was studied
- Sample size
- 882
Study quality details
- Study design
- Retrospective cohort
- Sample size
- 882
- Randomization
- no
- Blinding
- not stated
- Comparator
- not stated
- Follow up duration
- not stated
- Outcome type
- hard
- Replication
- not assessed (auto)
- Consistency with other evidence
- not assessed (auto)
- Population applicability
- UNKNOWN
- Statistical precision
- CI reported: 95% CI, -0
- Risk of bias
- not assessed (auto)
- Funding conflicts
- unclear
- Peer review status
- yes
02Funding
Funding and conflicts
- Funding
- not reported in abstract
- Industry funded
- Unclear
- Manufacturer
- None identified
- Sponsor role
- not reported in abstract
- Author conflicts
- The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
- Independent replication
- unknown
Funding is shown on every study and never used to score it.
04Source
The source, as retrieved
Abstract
[AIMS] Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been hypothesized to confer anti-inflammatory, antinociceptive, and anti-addictive benefits. We aimed to investigate their impact on acute perioperative pain and opioid use after total joint arthroplasty (TJA). [METHODS] A retrospective cohort study analyzed 14,375 hip or knee arthroplasties performed between January 2018 and February 2026, which included 882 patients on chronic preoperative GLP-1RA therapy. Using 1:1 propensity-score matching without replacement, 786 GLP-1RA users were matched to 786 non-users (total n=1,572) based on demographics, surgery type, and chronic medication use. [RESULTS] In the matched cohort, chronic GLP-1RA use was not associated with reduced inpatient opioid administration (adjusted difference -0.18; 95% CI, -0.74 to 0.38; p=0.53) or corrected postoperative morphine milligram equivalents (MME) (-2.79 MME; 95% CI, -6.95 to 1.37; p=0.19). When normalized to hospitalization time, the difference in inpatient opioid exposure was not statistically significant (+0.073 MME/hour; 95% CI, -0.003 to 0.149; p=0.059). Average visual analog scale (VAS) pain scores also showed no significant difference (-0.094; p=0.15). However, GLP-1RA users demonstrated a consistently shorter length of stay (LOS) (adjusted difference -10.41 hours; 95% CI, -13.97 to -6.85; p<0.001). [CONCLUSIONS] Chronic preoperative GLP-1RA therapy was not associated with reduced inpatient opioid exposure or improved early postoperative pain control following TJA. Nevertheless, GLP-1RA use was consistently associated with shorter hospital LOS. Prospective studies are needed to determine whether this finding reflects improved recovery pathways or residual confounding and to evaluate the impact of GLP-1RAs on longer-term postoperative outcomes and opioid utilization.