GLP-1 Receptor Agonists and the Risk of Thyroid Cancer

Bezin, Julien; Gouverneur, Amandine; Pénichon, Marine; Mathieu, Clément; Garrel, R.; Hillaire‐Buys, Dominique; Pariente, Antoine; Faillie, Jean‐Luc

doi:10.2337/dc22-1148

Cited by 101 publications

(61 citation statements)

References 17 publications

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“…Previous findings regarding possible pro-oncogenic characteristics of GLP-1 RA have been inconsistent. Several studies have shown that incretin-based drugs are associated with increased risk of multiple cancer types 8 , 22 – 24 . A recent real-world study using FAERS data from the first quarter of 2004 to the second quarter of 2020 reported significant signals between GLP-1RA and certain tumors, including medullary thyroid cancer, papillary thyroid cancer, malignant pancreatic neoplasms, islet cell neoplasms and APUDoma NEC.…”

Section: Discussionmentioning

confidence: 99%

Endogenous incretin levels and risk of first incident cancer: a prospective cohort study

Jujić

Godina

Belting

et al. 2023

Sci Rep

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Concerns have been raised regarding a potentially increased risk of cancer associated with treatment with glucagon-like peptide-1 (GLP-1) receptor agonists. Here, we explored whether fasting and oral glucose tolerance test post-challenge glucose-dependent insulinotropic peptide (GIP) and GLP-1 levels were associated with incident first cancer. Within the cardiovascular re-examination arm of the population-based Malmö Diet Cancer study (n = 3734), 685 participants with a previous cancer diagnosis were excluded, resulting in 3049 participants (mean age 72.2 ± 5.6 years, 59.5% women), of whom 485 were diagnosed with incident first cancer (median follow-up time 9.9 years). Multivariable Cox-regression and competing risk regression (death as competing risk) were used to explore associations between incretin levels and incident first cancer. Higher levels of fasting GLP-1 (462 incident first cancer cases/2417 controls) showed lower risk of incident first cancer in competing risk regression (sub-hazard ratio 0.90; 95% confidence interval 0.82–0.99; p = 0.022). No association was seen for fasting GIP, post-challenge GIP, or post-challenge GLP-1 and incident first cancer. In this prospective study, none of the fasting and post-challenge levels of GIP and GLP-1 were associated with higher risk of incident first cancer; by contrast, higher levels of fasting GLP-1 were associated with lower risk of incident first cancer.

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Section: Discussionmentioning

confidence: 99%

Endogenous incretin levels and risk of first incident cancer: a prospective cohort study

Jujić

Godina

Belting

et al. 2023

Sci Rep

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“…A recent nested case‐control study by Bezin et al 11 using the French health insurance claims database, reported an increased risk of thyroid cancer with GLP‐1RAs (adjusted HR 1.58, 95% CI 1.27‐1.95). A nested case‐control design and risk set sampling were applied to that study to minimize potential bias.…”

Section: Discussionmentioning

confidence: 99%

Risk of thyroid cancer associated with glucagon‐like peptide‐1 receptor agonists and dipeptidyl peptidase‐4 inhibitors in patients with type 2 diabetes: A population‐based cohort study

Bea,

Son,

Bae

et al. 2023

Diabetes Obesity Metabolism

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AimsTo determine the potential association between the use of either glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) or dipeptidyl peptidase‐4 (DPP‐4) inhibitors, and the risk of thyroid cancer in individuals with type 2 diabetes.Materials and MethodsThis population‐based cohort study used claims data from the Korean National Health Insurance Database, 2014‐2020. Two distinct cohorts were established to compare each incretin‐based drug with sodium‐glucose cotransporter‐2 (SGLT2) inhibitors, chosen as active comparators because of their previous non‐association with thyroid cancer, and their common usage as add‐on therapy to metformin along with GLP‐1RAs and DPP‐4 inhibitors. The first cohort included 21 722 new users of GLP‐1RAs and 326 993 new users of SGLT2 inhibitors, whereas the second cohort included 904 300 DPP‐4 inhibitor new users and 112 017 SGLT2 inhibitor new users. The outcome was the time to incident thyroid cancer. Weighted Cox proportional models were used to estimate hazard ratios of thyroid cancer incidence associated with incretin‐based drugs of interest.ResultsThe use of GLP‐1RAs was not associated with an increased risk of thyroid cancer (weighted hazard ratio 0.98, 95% confidence interval 0.62‐1.53) compared with that of SGLT2 inhibitors. Using DPP‐4 inhibitors was also not associated with an increased risk of thyroid cancer (0.95, 0.79‐1.14) compared with that of SGLT2 inhibitors. No significant effect modifications were observed across subgroup analyses. Sensitivity analyses, including alternative outcome definition analysis of medullary thyroid cancer, were consistent with the primary analysis results.ConclusionsGLP‐1RAs and DPP‐4 inhibitors were not associated with an increased risk of thyroid cancer in individuals with type 2 diabetes.

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“…In addition, the analysis of cases reported in the European Pharmacovigilance Database showed that the use of GLP-1 analogs is associated with a higher risk of developing thyroid cancer [ 126 ]. In a recently published study, which analyzed a total of 2526 cases of patients with thyroid cancer compared with 45,184 people from the control group, it was shown that the use of GLP-1 analogs for 1–3 years was associated with an increased risk of all thyroid cancers [ 127 ]. Attention should also be paid to the increased risk of tachycardia and arrhythmia during treatment with semaglutide [ 128 ].…”

Section: Treatment Of Obesitymentioning

confidence: 99%

Obesity in Adults: Position Statement of Polish Association for the Study on Obesity, Polish Association of Endocrinology, Polish Association of Cardiodiabetology, Polish Psychiatric Association, Section of Metabolic and Bariatric Surgery of the Association of Polish Surgeons, and the College of Family Physicians in Poland

Olszanecka-Glinianowicz

Mazur

Chudek

et al. 2023

Nutrients

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Obesity in adults and its complications are among the most important problems of public health. The search was conducted by using PubMed/MEDLINE, Cochrane Library, Science Direct, MEDLINE, and EBSCO databases from January 2010 to December 2022 for English language meta-analyses, systematic reviews, randomized clinical trials, and observational studies from all over the world. Six main topics were defined in the joint consensus statement of the Polish Association for the Study on Obesity, the Polish Association of Endocrinology, the Polish Association of Cardio-diabetology, the Polish Psychiatric Association, the Section of Metabolic and Bariatric Surgery of the Society of Polish Surgeons, and the College of Family Physicians in Poland: (1) the definition, causes and diagnosis of obesity; (2) treatment of obesity; (3) treatment of main complications of obesity; (4) bariatric surgery and its limitations; (5) the role of primary care in diagnostics and treatment of obesity and barriers; and (6) recommendations for general practitioners, regional authorities and the Ministry of Health. This statement outlines the role of an individual and the adequate approach to the treatment of obesity: overcoming obstacles in the treatment of obesity by primary health care. The approach to the treatment of obesity in patients with its most common complications is also discussed. Attention was drawn to the importance of interdisciplinary cooperation and considering the needs of patients in increasing the long-term effectiveness of obesity management.

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GLP-1 Receptor Agonists and the Risk of Thyroid Cancer

Cited by 101 publications

References 17 publications

Endogenous incretin levels and risk of first incident cancer: a prospective cohort study

Endogenous incretin levels and risk of first incident cancer: a prospective cohort study

Risk of thyroid cancer associated with glucagon‐like peptide‐1 receptor agonists and dipeptidyl peptidase‐4 inhibitors in patients with type 2 diabetes: A population‐based cohort study

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