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GLP-1 receptor agonists and thyroid cancer risk

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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GLP-1 Receptor Agonists and the Risk of Thyroid Cancer

A French nested case-control analysis (n=2,562 cases matched to 45,184 controls) found use of glucagon-like peptide 1 receptor agonists for 1-3 years was associated with an increased risk of thyroid cancer (adjusted HR 1.58, 95% CI 1.27-1.95)

Key points:

  • preclinical studies suggest that GLP-1 receptor agonists have specific effects on the thyroid gland, potentially involving the development of thyroid cancer
    • studies on this subject produced conflicting results, potentially due to a lack of statistical power.
  • results of this nationwide population-based study suggest that use of GLP-1 receptor agonists is associated with increased risk of thyroid cancer.
  • increased risk was higher in the case of 1-3 years of GLP-1 receptor agonist use
  • clinicians should be aware of this potential risk in initiating a GLP-1 receptor agonist and carefully monitor exposed patients

A systematic review and meta-analysis found that GLP-1 receptor agonist treatment was associated with an increased risk of overall thyroid cancer (OR 1.52, 95%CI 1.01-2.29) (2).

A study (n=145,410 on GLP-1 receptor agonists and 291,667 on DPP-4 inhibitors) (3):

  • found GLP1RAs not linked to increased risk of thyroid cancer over mean follow-up of 3.9 years (occurred in 76 on GLP-1 receptor agonists and 184 on DPP-4 inhibitors; incidence rate 1.33 vs 1.46 events/10,000 person-years, respectively, HR 0.93, 95% CI 0.66-1.31)

Reference:

  1. Bezin J et al. GLP-1 Receptor Agonists and the Risk of Thyroid Cancer. Diabetes Care 2022; dc221148. https://doi.org/10.2337/dc22-1148
  2. Silverii GA, Monami M, Gallo M, et al. Glucagon-like peptide-1 receptor agonists and risk of thyroid cancer: A systematic review and meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2023; 1-10. doi:10.1111/dom.15382
  3. Pasternak B et al. Glucagon-like peptide 1 receptor agonist use and risk of thyroid cancer: Scandinavian cohort study BMJ 2024; 385 :e078225 doi:10.1136/bmj-2023-078225

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