Hormonal
Lixisenatide and high-dose efpeglenatide (6 mg/week) are associated with a statistically significant increase in hearing loss events compared to controls, whereas other GLP-1 receptor agonists and SGLT2 inhibitors do not demonstrate this elevated risk.
If you are taking Lixisenatide or high-dose Efpeglenatide, be aware of a potential increased risk of hearing loss. This risk is not seen with other GLP-1 drugs like Semaglutide or Dulaglutide in this analysis. Report any sudden hearing changes to your doctor immediately, but do not stop your medication without consulting them, as the absolute risk (NHH ~757) is relatively low.
Our NMA of 29 RCTs with 145,895 participants found that only two exendin-4 derivatives—lixisenatide and high-dose efpeglenatide (i.e., 6 mg/week)—showed increased hearing loss events compared to controls. No other GLP-1 receptor agonists or SGLT2 inhibitors demonstrated significantly elevated hearing loss risk.
Why this rating
Network Meta-Analysis of 29 RCTs with >145,000 participants, though the mechanism is theoretical.
Source
Risk of Hearing Loss in Patients Treated with Exendin-4 Derivatives: A Network Meta-Analysis of Glucagon-like Peptide-1 Receptor Agonists and Sodium–Glucose Cotransporter 2 Inhibitors
Jiann-Jy Chen et al. · Pharmaceuticals · 2025
DOI 10.3390/ph18050735
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