In a comprehensive cohort study spanning Denmark, Norway, and Sweden, researchers explored whether the use of glucagon-like peptide 1 (GLP1) receptor agonists in patients with type 2 diabetes increased the risk of thyroid cancer. The drugs involved include liraglutide, semaglutide, dulaglutide, and others.
Researchers collected data from national healthcare and cancer registers, following patients aged 18-84 who were new users of either GLP1 receptor agonists or dipeptidyl peptidase 4 (DPP4) inhibitors. This active-comparator design allowed the researchers to directly compare thyroid cancer incidences in both groups. After following up for several years, the findings were clear: GLP1 receptor agonists did not significantly increase the risk of thyroid cancer compared to DPP4 inhibitors.
“We found no significant association between GLP1 use and an overall increased risk of thyroid cancer,” said Peter Ueda, assistant professor at Karolinska Institutet. “Our results offer reassurance to patients and healthcare providers concerned about the potential risks of these medications.”
Interestingly, the analysis also examined thyroid cancer subtypes, such as papillary and medullary cancers, and again found no meaningful increase in risk. Some researchers believe that while overall risk remains low, more studies focusing on smaller, specific populations may yield insights into rare cases where risk might be heightened.
The study applied several statistical models, including propensity score weighting and Cox regression, to ensure robustness in its findings. Furthermore, lag period analyses were performed, exploring whether the risk changed after one or two years of treatment initiation. These analyses showed no significant increase in cancer risk, even with longer drug exposure.
While the study reassures patients that GLP1 receptor agonists do not pose an overall increased thyroid cancer risk, Ueda noted that those with a genetic predisposition to certain thyroid cancer subtypes should continue to exercise caution.
These findings are critical given the widespread use of GLP1 receptor agonists, especially in patients managing both diabetes and obesity. The results align with previous studies conducted in the U.S. and France, which also found no significant link between GLP1 drugs and thyroid cancer.
Citation:
Pasternak B, Ueda P, Wintzell V, Hviid A. Glucagon-like peptide 1 receptor agonist use and risk of thyroid cancer: Scandinavian cohort study. BMJ. 2024;385. doi:10.1136/bmj-2023-078225
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