Risk of peripheral vestibular disorders and hearing impairment among users of glucagon-like peptide-1 receptor agonists

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used antidiabetic agents with established glycemic efficacy. Peripheral vestibular disorders and hearing impairment are inner ear conditions that may be influenced by metabolic and glycemic status. This study aimed to investigate the association between GLP-1 RA use and the development of peripheral vestibular disorders, dizziness, and hearing impairment. This retrospective cohort study identified patients who received GLP-1 RA treatment and matched them with non-GLP-1 RA users. After propensity score matching, a total of 684,092 participants were included, with 342,046 in the GLP-1 RA group and 342,046 in the non-GLP-1 RA groups. The primary outcomes were newly diagnosed peripheral vestibular disorders, dizziness, and hearing impairment. Cox proportional hazards regression models were applied to compare outcome incidences between groups. During the follow-up period, 4,407 cases of peripheral vestibular disorders occurred in the GLP-1 RA group compared with 3,946 cases in the non-GLP-1 RA group, indicating a significantly higher incidence among GLP-1 RA users (P < 0.001). Dizziness was diagnosed in 32,545 GLP-1 RA users and 29,931 nonusers, while hearing impairment occurred in 9,522 and 7,898 participants, respectively; both outcomes were significantly more frequent in the GLP-1 RA group (P < 0.001). Cumulative incidence analyses showed significantly higher risks for all three outcomes in the GLP-1 RA group. In conclusion, GLP-1 RA use may presented be with higher incidences of peripheral vestibular disorders, dizziness, and hearing impairment in white population.