GLP-1s reduce thrombosis risk among people with diabetes, regardless of obesity
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Key takeaways:
- Individuals who took GLP-1 receptor agonists for type 2 diabetes exhibited reduced risk for thrombosis.
- The finding persisted regardless of obesity.
SAN DIEGO — Glucagon-like peptide-1 receptor agonists reduced risk for venous thromboembolism among patients with type 2 diabetes, according to retrospective study results presented at ASH Annual Meeting and Exposition.
Researchers did not observe significant differences in risk based on patients’ weight, indicating the benefit persists for those with obesity and those without.
“The trend of VTE has continuously gone up over the years and, with the increasing prescription of GLP-1 receptor agonists, there is potential to see if the overall burden of VTE might be reduced at a population level,” Cho Han Chiang, MD, junior medical resident at Mount Auburn Hospital, told Healio.
Background and methods
VTE affects approximately 1 in 1,000 individuals in the United States. The condition is responsible for about 100,000 deaths annually, Chiang said.
VTE incidence has increased 20% during the past 10 years, study lead author Rushad Patell, MD, assistant professor of medicine at Harvard Medical School, added during a press briefing.
Individuals with obesity can have 2-3 times the risk for VTE, and between 10% to 30% of VTEs have been attributable to obesity, Patell said.
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) initially received FDA approval to treat type 2 diabetes mellitus. They since have been shown to help with weight loss.
“Given that obesity is a strong risk factor for the occurrence of VTE, our hypothesis was that GLP-1RAs may reduce the risk for VTE partly via their weight loss effects,” Chiang said.
Researchers used the TriNetX Analytics Network, which includes health records for more than 250 million people from more than 120 health care institutions around the world, to identify individuals with type 2 diabetes mellitus who received either GLP-1RAs or dipeptidyl peptidase-IV (DPP-IV).
Both medications “target the incretin system and increase insulin secretion,” researchers wrote. This helps to achieve glycemic control.
The study population consisted of two cohorts, each of which included 168,428 people. People in one cohort received GLP-1Ras, and those in the other cohort received DPP-IV.
Incidence of VTE per 1,000 patient-years 1 year after first use of one of the medications served as the primary endpoint. Incidence of pulmonary embolism and deep venous thrombosis served as secondary endpoints.
Results and next steps
Results showed lower VTE incidence in the GLP-1RA group than the DPP-IV group (6.5 per 1,000 vs. 7.9 per 1,000; HR = 0.8; 95% CI, 0.75-0.85).
Researchers also observed lower risk for PE (HR = 0.78; 95% CI, 0.71-0.85) and DVT (HR = 0.82; 95% CI, 0.75-0.88) in the GLP-1RA group.
Researchers did not observe a significant difference between patients with obesity and those without it.
“We were surprised by the finding that VTE reduction was observed among both patients with obesity and those without obesity,” Chiang said. “We initially thought that given the weight loss effect of GLP-1RAs, there would likely be a greater degree of VTE reduction among patients with obesity. Our observation that GLP-1RAs may also reduce VTE among patients without obesity seems to suggest that there might be effects other than the weight loss driving the reduction in VTE.”
The findings still need to be validated in prospective studies, Chiang said.
GLP-1RAs also should be evaluated in other populations, researchers noted. These include people without diabetes, those who are taking drugs as part of weight loss efforts, and those who may be at greater risk for VTE because of cardiovascular conditions, cancer or other factors.
“From a public health perspective, given how prevalent these drugs are, there is potential to see if the overall burden of VTE might be reduced at a national or population level,” Patell said in an ASH press release. “VTE risk seems to continuously go up; maybe this will bring the curve down.”
For more information:
Cho Han Chiang, MD, can be reached at chohan.chiang@mah.harvard.edu.
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Chiang CH, et al. Abstract 701. Presented at: ASH Annual Meeting and Exposition; Dec. 7-10, 2024; San Diego.
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