‘No observed increase’ in pancreatic cancer among patients with type 2 diabetes on GLP-1RAs
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Key takeaways:
- Patients with type 2 diabetes on GLP-1RAs had a significantly lower risk for pancreatic cancer vs. those on other antidiabetic treatments.
- Results were consistent among those with obesity or overweight.
PHILADELPHIA — Patients with type 2 diabetes on glucagon-like peptide-1 receptor agonists had significantly lower risk for pancreatic cancer compared with those on other antidiabetic therapies, regardless of weight, according to data.
“Glucagon-like peptide-1 receptor agonist medications (GLP-1RAs) are commonly prescribed to manage diabetes mellitus, and given their mechanism of action on the pancreas, it is crucial to investigate whether they could potentially contribute to pancreatic cancer development,” Khaled Alsabbagh Alchirazi, MD, a gastroenterologist at Aurora Healthcare in Wisconsin, told Healio. “Our study aimed to address this concern.”
Using deidentified electronic health records, Alchirazi and colleagues identified 4,950,000 patients with a history of type 2 diabetes between 2005 and 2020, of whom 245,532 were on GLP-1RAs. All patients were drug naive with no history of pancreatic cancer at baseline.
The researchers compared GLP-1RAs with insulin, metformin, alpha-glucosidase inhibitors, dipeptidyl-peptidase 4 (DPP-4) inhibitors, sodium-glucose cotransporter-2 (SGLT2) inhibitors, sulfonylureas and thiazolidinediones, and matched patients 1:1 based on demographics, lifestyle factors, medical history and family history of disease, among others.
According to results presented at the ACG Annual Scientific Meeting, the risk for pancreatic cancer was significantly lower among patients on GLP-1 RAs vs. insulin (HR = 0.56; 95% CI, 0.44-0.72), DPP-4 inhibitors (HR= 0.8; 95% CI, 0.73-0.89), SGLT2 inhibitors (HR = 0.78; 95% CI, 0.69-0.89) and sulfonylureas (HR = 0.84; 95% CI, 0.74-0.95).
“This was consistent across different groups,” Alchirazi told Healio, including patients with obesity or overweight on GLP-1RAs vs. insulin (HR = 0.53; 95% CI, 0.43-0.65) and SGLT2 inhibitors (HR = 0.81; 95% CI, 0.69-0.96).
“While previous reports suggested a possible association between pancreatic cancer and GLP-1RA medications, this study provides reassurance that there is no observed increase in the incidence of pancreatic cancer among patients using these GLP-1RAs,” Alchirazi said. “Additional research is needed to explore the underlying mechanisms of the observed effects and to better understand the relationship between GLP-1RA therapy and pancreatic cancer risk. This could include studies investigating the biological pathways involved and long-term outcomes in diverse patient populations.”
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Alchirazi KA, et al. GLP-1 receptor agonists and pancreatic cancer risk in drug-naive patients with type 2 diabetes. Presented at: ACG Annual Scientific Meeting; Oct. 25-30, 2024; Philadelphia (hybrid meeting).
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