VESS12 - GLP-1 Receptor Agonists are Associated with Fewer Major Complications, Hospital Admissions, and Better Venous Ulcer Healing

Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs)—such as tirzepatide and semaglutide—have been shown to decrease rates of major adverse cardiac events and mortality independent of weight loss. Despite their well-documented cardiovascular benefits, their impact on venous ulcer healing has not been investigated. The objective of this study was to evaluate the effects of GLP-1 RAs on wound healing in patients with chronic venous ulcers.

Methods: Data was sourced from the TriNetX research network, encompassing 101 health care organizations. We utilized a 1:1 propensity-matched study to compare patients with an active venous ulcer and started on GLP-1 RAs (Group 1) with those who were not started on GLP-1 RAs (Group 2). To control for differences in the cohorts, we controlled for age, race, sex, diabetes status, smoking history, previous peripheral angioplasty, and baseline weight. Outcomes included wound healing, inpatient admission, major adverse cardiovascular events (MACE), and major adverse limb events (MALE) which were identified using ICD-10 codes. Patients with arterial insufficiency defined by an abnormal ankle-brachial index were excluded.

Results: We identified 381,512patients with venous ulcers between October 1, 2022, and December 31, 2023. After propensity matching, we arrived at a study population of 38,834 matched pairs. Patients in Group 1 were found to have a higher starting mean weight (247 ± 68.2 vs 216 ± 64.2, P=.001) and hemoglobin A1c (7.7 ± 0.8 vs 7.2 ± 0.8, P< 0.01). At the one-year follow-up period, Group 1 exhibited more weight loss (240 ± 65.0 vs 212 ± 63.5, P<.01), fewer non-healing ulcers (0.61% vs 0.92%, P<.01), fewer inpatient admissions for wound-related infection (18.4% vs 30.8%, P<.01). Both MACE and MALE were decreased in Group 1 (Table I). Cox multivariate regression analysis found GLP-1 RAs to be significantly associated with decreased risk of persistence of wounds, soft tissue infection, inpatient admission, and MACE (Figure 1).

Conclusions: The use of GLP-1 RAs is associated with improved venous ulcer healing. Patients with venous ulcers treated with GLP-1 RAs are also less likely to be admitted to the hospital with wound-associated complications and major adverse cardiovascular events.