GLP-1 receptor agonist tied to similar thyroid cancer risk as DPP-IV, SGLT2 inhibitors
Click Here to Manage Email Alerts
Key takeaways:
- Of 145,410 adults who began a GLP-1 drug, 76 developed thyroid cancer over a mean 3.9 years of follow-up.
- Risk for thyroid cancer with GLP-1s was similar to that with DPP-IV and SGLT2 inhibitor therapy.
Adults who initiate a GLP-1 receptor agonist have a similar risk for developing thyroid cancer as those prescribed a DPP-IV inhibitor or an SGLT2 inhibitor, according to study findings published in The BMJ.
“GLP-1 receptor agonist use was not associated with a substantially increased risk of thyroid cancer over a mean follow-up of 3.9 years,” Björn Pasternak, MD, PhD, associate professor and principal researcher in the division of pharmacoepidemiology, department of medicine at Karolinska Institutet in Sweden, and colleagues wrote. “The study was based on more than 145,000 patients who started GLP-1 receptor agonist treatment and had high statistical precision; given the upper limit of the confidence interval, the findings are incompatible with an increased relative risk of thyroid cancer of more than 31%.”
Researchers conducted a population-based cohort study of adults aged 18 to 84 years who started GLP-1 receptor agonist therapy. Data were collected from health care and administrative registers in Denmark and Sweden from 2007 to 2021 and from Norway from 2010 to 2018. Propensity score matching was conducted to match new GLP-1 users with adults who used a DPP-IV inhibitor. Additional analysis also compared adults who received a GLP-1 with those who received an SGLT2 inhibitor. Diagnoses of incident thyroid cancer were collected.
There were 145,410 adults who initiated GLP-1 receptor agonist therapy (mean age, 57.5 years; 53.2% men) matched with 291,667 adults receiving a DPP-IV inhibitor. Of those receiving a GLP-1, 57.3% received liraglutide (Saxenda, Novo Nordisk) and 32.9% received semaglutide (Ozempic/Wegovy, Novo Nordisk).
During follow-up, 76 adults in the GLP-1 group and 184 in the DPP-IV group were diagnosed with thyroid cancer. No difference in thyroid cancer risk was observed between the two groups. There were also no differences between the two group in risks for any specific type of thyroid cancer.
In additional analysis, 111,744 adults receiving a GLP-1 receptor agonist were matched with 148,179 adults initiating an SGLT2 inhibitor. No difference in thyroid cancer risk was observed between the two groups.
“Although pharmacovigilance studies have found increased reporting rates for thyroid cancer with GLP-1 receptor agonists, disproportionality analyses are designed to detect potential safety signals but are not intended to make causal conclusions,” the researchers wrote. “Given that thyroid cancer is mentioned in the product label as a potential adverse event, spontaneous reporting might have been driven by physician and public awareness.”
The researchers said more studies are needed to examine thyroid cancer risk over a longer follow-up period and to assess risk for individual drugs.
Collapse
Click Here to Manage Email Alerts