GLP-1 receptor agonists may protect against CRC in patients with type 2 diabetes
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Key takeaways:
- Glucagon-like peptide 1 receptor agonists were associated with a decreased risk for CRC compared with insulin and metformin.
- GLP-1RAs also were associated with a lower CRC risk in overweight and obese patients.
Glucagon-like peptide 1 receptor agonists were associated with a reduced risk for colorectal cancer among patients with type 2 diabetes, regardless of weight status, compared with other antidiabetics, according to research.
“To our knowledge, this is the first indication this popular weight-loss and antidiabetic class of drugs reduces incidence of CRC, relative to other antidiabetic agents,” Rong Xu, PhD, co-lead researcher and professor of biomedical informatics at Case Western Reserve University School of Medicine, said in a related university press release.
To compare the effects of glucagon-like peptide 1 receptor agonists (GLP-1RAs) and non-GLP-1RAs on the risk for CRC, Xu and colleagues conducted a nationwide, retrospective cohort study using deidentified electronic health records obtained via the TriNetX platform.
They included 1,221,218 drug-naive patients with type 2 diabetes from 59 health care organizations nationwide who were prescribed antidiabetic medications from 2005 to 2019. Patients were propensity score matched for demographics, socioeconomic and lifestyle factors, medical history and procedures such as colonoscopy.
The non-GLP-1RAs used for comparison were insulin, metformin, alpha-glucosidase inhibitors, dipeptidyl-peptidase 4 (DPP-4) inhibitors, sodium-glucose cotransporter-2 (SGLT2) inhibitors, sulfonylureas and thiazolidinediones.
The primary outcome was the first diagnosis of CRC within 15 years of the first prescription date.
According to results published in JAMA Oncology, GLP-1RAs were associated with a decreased risk for CRC compared with insulin (HR = 0.56; 95% CI, 0.44-0.72), metformin (HR = 0.75; 95% CI, 0.58-0.97), SGLT2 inhibitors (HR = 0.77; 95% CI, 0.62-0.97), sulfonylureas (HR = 0.82; 95% CI, 0.68-0.98) and thiazolidinediones (HR = 0.82; 95% CI, 0.69-0.97).
Researchers also reported GLP-1RAs were associated with a “lower but not statistically significant” risk for CRC compared with alpha-glucosidase (HR = 0.59; 95% CI, 0.31-1.13) or DPP-4 inhibitors (HR = 0.93; 95% CI, 0.78-1.1).
Further, GLP-1RAs were associated with a decreased risk for CRC among those classified as obese or overweight compared with insulin (HR = 0.5; 95% CI, 0.33-0.75), metformin (HR = 0.58; 95% CI, 0.38-0.89) or other antidiabetics.
“Our results clearly demonstrate that GLP-1RAs are significantly more effective than popular antidiabetic drugs, such as metformin or insulin, at preventing the development of CRC,” Nathan Berger, MD, co-lead researcher and Hanna-Payne Professor of Experimental Medicine at Case Western Reserve School of Medicine, said in the release. “The research is critically important for reducing incidence of CRC in patients with diabetes, with or without overweight and obesity.”
Reference:
- New Case Western Reserve University study finds diabetes drug may reduce risk for colorectal cancer. Available at: https://www.newswise.com/articles/new-case-western-reserve-university-study-finds-diabetes-drug-may-reduce-risk-for-colorectal-cancer#:~:text=%E2%80%9COur%20results%20clearly%20demonstrate%20that,Medicine%20and%20the%20study's%20co. Published Dec. 7, 2023. Accessed Dec. 07, 2023.
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