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:
- 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
- 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
- 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