Association of Glucagon-Like Peptide-1 Receptor Analogues and Laryngeal Symptoms in Obese Adults.

OBJECTIVES: Given the unprecedented rise in glucagon-like peptide-1 receptor analogue (GLP-1RA) therapy over the past decade, we aimed to investigate potential unintended laryngeal manifestations. METHODS: A retrospective cohort study was conducted using the TriNetX United States Collaborative Network. Adults with obesity on GLP-1RA medications (n = 617,296) from January 1, 2016 to December 3, 2025, were compared with controls (n = 3,503,102), excluding patients with head and neck neoplasms, head and neck radiation therapy, autoimmune diseases, airway disorders or acute respiratory conditions via ICD-10 and CPT codes. Laryngeal symptoms within 1, 3, and 6 months of initiation of GLP-1RA were assessed in propensity score-matched cohorts by age, sex, race, and ethnicity. Outcomes were reported as risk differences (RD) and odds ratios (OR) with 95% confidence intervals (CI). RESULTS: GLP-1RA therapy increased the 6-month risk of any laryngeal manifestations (OR 1.19, 95% CI 1.16-1.21; p < 0.0001). Higher odds were observed for cough (OR 1.46, p < 0.0001), foreign body sensation (OR 1.1.41, p < 0.001), and voice and resonance disorders (OR 1.19, p = 0.002). Across agents, exenatide, liraglutide, semaglutide, dulaglutide, and lixisenatide showed significant elevated 6-month risk of laryngeal manifestations (OR 1.16-1.91-1.48; p < 0.05), while albiglutide and tirzepatide did not. CONCLUSION: GLP-1RA/GIP use in adults is linked to higher rates of laryngeal symptoms, most notably cough and voice and resonance disorders. While absolute risk differences were small, the large number of affected individuals underscores the potential clinical and public health relevance of these findings, in the context of the rapidly growing prevalence of GLP-1RA/GIP use.