New Study Finds No Substantial Increase in Thyroid Cancer Risk with GLP-1 Receptor Agonist Use

A large Scandinavian cohort study published in BMJ (doi: 10.1136/bmj-2023-078225) provides reassurance for patients and healthcare professionals concerning the use of glucagon-like peptide 1 (GLP-1) receptor agonists, a class of drugs used in the treatment of type 2 diabetes. The research carried out across Denmark, Norway, and Sweden from 2007 to 2021, investigated the hypothesized link between these medications and the risk of developing thyroid cancer.

Concerns about thyroid cancer with GLP-1 receptor agonist use first emerged from preclinical studies showing increased rates of thyroid C cell tumors in rodents. While human relevance wasn't established, warning labels and contraindications for patients with a personal or family history of certain types of thyroid cancer or diseases were added to medications in the United States.

The study compared 145,410 patients treated with GLP-1 receptor agonists against 291,667 patients who started dipeptidyl peptidase 4 (DPP4) inhibitors, typically used in similar disease stages without known thyroid cancer signals. Researchers utilized nationwide cancer registers, leveraging the active-comparator, new-user study design, and Cox regression for hazard ratios, to control for potential confounders with propensity score weighting.

With a mean follow-up of 3.9 years, there was no substantial increased risk of thyroid cancer associated with GLP-1 receptor agonists. The incidence rates were 1.33 events per 10,000 person-years for GLP-1 receptor agonists and 1.46 events for DPP4 inhibitors. Hazard ratio analysis also indicated no strong association with medullary thyroid cancer or any other specific subtype.

This comprehensive study, factoring in various potential biases and confounding factors, suggests that the use of GLP-1 receptor agonists is not associated with a significantly higher risk of developing thyroid cancer compared to DPP4 inhibitors, with the upper limit of the confidence interval suggesting no more than a 31% increase in relative risk.

Patients and healthcare professionals may be reassured by these findings, which align with a conclusion from the European Medicines Agency that available evidence does not support a causal association between GLP-1 receptor agonist usage and increased thyroid cancer risk.

For more detailed information on the study and its findings, please visit the BMJ website at http://dx.doi.org/10.1136/bmj-2023-078225.

This news article was crafted with the help of Buoy Health.