GLP-1 Receptor Agonist Use and A1 Pulley Release After Corticosteroid Injection for Trigger Finger in Type 2 Diabetes

Background: Patients with type 2 diabetes mellitus (T2DM) have a higher incidence of trigger finger and are more likely to require operative A1 pulley release. The impact of glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy on treatment progression remains unclear. This study evaluated the association between GLP-1RA use and progression to operative A1 pulley release following corticosteroid injection for trigger finger in patients with T2DM. Methods: A retrospective analysis was conducted using the TriNetX Research Network to identify adults with T2DM and trigger finger who underwent an initial corticosteroid injection. Patients were grouped by GLP-1RA exposure and propensity-matched (1:1) for demographics, comorbidities, and other diabetic medications. The primary outcome was A1 pulley release at 6, 12, and 24 months after injection. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated, and balance was assessed using standardized mean differences <0.10. Results: A total of 69 222 patients met inclusion criteria (5871 with GLP-1RA exposure and 63 351 without). After matching, 5863 patients remained in each cohort. Glucagon-like peptide-1 receptor agonist use was not associated with a significant difference in 6-month release rates (6.1% in GLP-1RA users vs 6.8% in nonusers). However, GLP-1RA users had lower release rates at 12 (10.6% vs 11.9%; RR, 0.89; 95% CI, 0.81-0.99; P = .027) and 24 months (14.2% vs 15.7%; RR, 0.90; 95% CI, 0.83-0.98; P = .016). These differences corresponded to absolute risk reductions of 1.4% and 1.7%, or numbers needed to treat of 71 and 59, at 12 and 24 months, respectively. Conclusion: Glucagon-like peptide-1 receptor agonist therapy was associated with a small but statistically significant reduction in progression to A1 pulley release at 12 and 24 months after corticosteroid injection for trigger finger in patients with T2DM. Level of evidence : Level III