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Risk of Suicide, Hair Loss, and Aspiration with GLP1-Receptor Agonists and Other Diabetic Agents: A Real-World

Michael Nakhla1, Ambica Nair2, Prachi Balani3

  • 1Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA, USA. Michael.Nakhla@StVincentHospital.com.

Cardiovascular Drugs and Therapy
|September 12, 2024
PubMed
Abstract

Insights

Glucagon-like peptide 1 receptor agonists (GLP1-RAs) showed increased reports for suicide, hair loss, and aspiration risks. However, these did not meet statistical criteria for safety signals, warranting continued monitoring.

Area of Science:

  • Pharmacovigilance and Drug Safety
  • Endocrinology and Metabolism
  • Clinical Pharmacology

Background:

  • Glucagon-like peptide 1 receptor agonists (GLP1-RAs) are increasingly prescribed for type 2 diabetes.
  • Growing popularity has led to concerns regarding potential adverse events, including suicide, hair loss, and aspiration.
  • Robust safety assessments are crucial for widely used medications.

Purpose of the Study:

  • To investigate and validate safety concerns associated with GLP1-RAs.
  • To compare the reporting rates of suicide, hair loss, and aspiration events for GLP1-RAs against other antidiabetic drug classes.

Main Methods:

  • A disproportionality analysis was conducted using data from four major pharmacovigilance databases (FAERS, DAEN, EudraVigilance, Vigibase).
  • GLP1-RAs were compared with sodium-glucose cotransporter 2 inhibitors (SGLT2is), dipeptidyl peptidase 4 inhibitors (DPP4is), sulfonylureas, metformin, and insulin.
  • Reporting odds ratio (ROR), proportional reporting ratio (PRR), and chi-squared (χ2) were calculated to detect safety signals, with positive signals defined as PRR > 2 and χ2 > 4.

Main Results:

  • No statistically significant safety signals were detected for GLP1-RAs concerning suicide, hair loss, or aspiration events.
  • GLP1-RAs showed higher reporting rates for hair loss compared to other antidiabetic classes.
  • While GLP1-RAs had numerically higher reports for suicidal ideation and aspiration events than SGLT2is and DPP4is, these did not reach the threshold for a positive signal.

Conclusions:

  • Despite increased reporting, GLP1-RAs did not meet predefined criteria for safety signals related to suicide, hair loss, or aspiration.
  • The observed higher reporting rates warrant continued pharmacovigilance and careful patient monitoring.
  • Further research may be needed to fully elucidate the risk-benefit profile of GLP1-RAs regarding these specific adverse events.
Keywords:
AspirationFAERSGLP-1 receptor agonistHair lossPharmacovigilanceSuicidality

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