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Do GLP-1–Receptor Agonists Increase Risk for Thyroid Cancer?
Glucagon-like peptide-1–receptor agonists (GLP-1–RAs) are widely used for type 2 diabetes and obesity management, but concerns have emerged regarding their potential association with thyroid cancer, given the increased GLP-1 receptor expression in thyroid cancer cells and preclinical findings of C-cell malignancies in rodents. While some observational studies suggest an increased risk, others report no association.
To investigate this potential association in patients with type 2 diabetes, researchers analyzed population-based databases from six countries and identified roughly 100,000 GLP-1–RA users and 2.5 million dipeptidyl peptidase-4 inhibitor (DPP-4i) users. The median follow-up period ranged from 1.8 to 3.0 years for GLP-1–RA users and from 2.8 to 6.8 years for DPP-4i users.
In mortality-adjusted Cox regression models, the pooled weighted hazard ratio for thyroid cancer among GLP-1–RA users compared with DPP-4i users was 0.81 (95% CI, 0.59–1.12), indicating no significant increase in thyroid cancer risk associated with GLP-1–RA use. Additionally, analyses considering cumulative GLP-1–RA doses did not reveal an elevated risk. Subgroup analyses for thyroid cancer subtypes (e.g., medullary thyroid cancer) were not feasible due to a low number of these outcomes.
Comment
These findings from the largest population study on this question so far suggest that GLP-1–RA use does not increase the risk for thyroid cancer in the short term, which is consistent with results from other recently reported observational studies using DPP-4i or sodium–glucose cotransporter-2 inhibitor as active comparators (Diabetes Obes Metab 2024; 26:108; BMJ 2024; 385:e078225). While this may offer reassurance to patients and clinicians regarding the safety of GLP-1–RAs, the relatively short follow-up periods in these studies limit conclusions about long-term risks.
Citation(s)
Author:
Baxter SM et al.
Title:
Glucagon-like peptide 1 receptor agonists and risk of thyroid cancer: An international multisite cohort study.
Source:
Thyroid
2025
Jan
; [e-pub].
(Abstract/FREE Full Text)
Empfohlen von
Hyunseok Kang, MD, MPH, FACP