Beyond Glycemic Control: Concurrent GLP-1 Receptor Agonist Use Is Associated with Reduced Urinary Adverse Events Following OnabotulinumtoxinA Treatment in Non-Diabetic Adults with Overactive Bladder.
Hammad. Muhammed A M MAM; Quesada. Sophia G SG; Belczyk. Aimee L AL; Ghoniem. Gamal M GM
Key Findings
- Semaglutide users had a lower rate of urinary retention (4.9% vs 8.6%) after Botox treatment
- Semaglutide users had fewer urinary‑tract infections (8.8% vs 13.3%)
- No difference in the need for antispasmodic drugs between groups
Practical Outcomes
- If you’re already using semaglutide for weight loss and need Botox for an overactive bladder, the drug may also lower your risk of retention and infections. Consider discussing with your clinician whether continuing semaglutide around the time of Botox could be beneficial, but remember the evidence is from a retrospective database and not a randomized trial.
Summary
A study of almost 2,000 non‑diabetic adults who got Botox for an overactive bladder found that those who were also taking the weight‑loss drug semaglutide had fewer problems with urinary retention and urinary‑tract infections than those who didn’t take the drug. The benefit seemed to go beyond just losing weight, suggesting semaglutide might help the bladder recover better after Botox. The research was retrospective and matched patients for age, race, blood pressure and body‑mass index, so it’s not a definitive proof but points to a possible added advantage.
Abstract
Semaglutide, a GLP-1 (glucagon-like peptide-1) receptor agonist, is widely prescribed for weight loss in non-diabetic populations. Given the link between obesity and overactive bladder (OAB), we explored whether GLP-1 use would improve adverse urinary events beyond its weight loss benefit for non-diabetic adults undergoing onabotulinumtoxin A (BTX-A) treatment for OAB. Using the TriNetX database, we conducted a retrospective cohort study of non-diabetic OAB patients treated with BTX-A alone or with concurrent GLP-1 therapy. Propensity score matching (1:1) was adjusted for age, race, ethnicity, hypertension, and BMI/obesity. After matching, 992 patients were included in each group. GLP-1 use was associated with a lower incidence of urinary retention (8.6% vs. 4.9%, risk difference 3.66%, <i>p</i> = 0.0044) and urinary tract infection (13.3% vs. 8.8%, risk difference 4.54%, <i>p</i> = 0.00224), with corresponding improved one-year retention-free and UTI-free survival on Kaplan-Meier (KM) analysis. Antispasmodic initiation rates were similar (11.8% vs. 10.3%, risk difference 1.55%, <i>p</i> = 0.6921), and KM analysis showed no significant difference. These findings suggest that GLP-1 receptor agonist use may improve select urinary adverse events in non-diabetic adults undergoing BTX-A treatment for OAB and support further investigation into its potential adjunctive role in OAB management with longer follow-up.
Study Information
pubmed
2025
2025-11-01T00:00:00.000Z
10.3390/toxins17110542
63