Glucagon-like peptide-1 receptor agonists and rotator cuff disease: a scoping review.

BACKGROUND

Obesity and type 2 diabetes mellitus (T2DM) are associated with impaired rotator cuff tendon healing and inferior clinical outcomes following surgical repair. Glucagon-like peptide-1 receptor agonists (GLP-1RA) are increasingly used to manage obesity and T2DM. However, their influence on rotator cuff disease biology and outcomes following cuff repair remains unknown.

METHODS

A scoping review was conducted in accordance with PRISMA-ScR guidelines. MEDLINE, Embase, PubMed, and the Cochrane Library were searched from inception to 28 January 2026 for studies evaluating associations between GLP-1RA exposure and rotator cuff disease. Eligible studies included human observational cohort studies and preclinical experimental studies. Data were extracted independently by two reviewers and synthesised descriptively.

RESULTS

Six studies were included, four human retrospective cohort studies and two controlled preclinical studies. The human studies included 1,481,529 patients, of which 391,716 were GLP-1RA users. Preoperative GLP-1RA use was not associated with increased postoperative complications following rotator cuff repair. However, GLP-1RA use was associated with increased incidence of atraumatic rotator cuff tears and subsequent repair. Preclinical models of acute rotator cuff injury and repair found that liraglutide improved biomechanical strength and organisation of the repaired tendon-bone interface, reduced fatty infiltration, and attenuated cellular stress responses.

CONCLUSIONS

The current evidence does not demonstrate an association between GLP-1RA use and increased risk of postoperative complications following rotator cuff repair. Studies reported an association between GLP-1RA use and higher incidence of atraumatic rotator cuff tears. Preclinical data suggest GLP-1RA may influence rotator cuff tissue healing. High-quality prospective studies are required to clarify the effects of GLP-1RA on rotator cuff disease.