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Risk of Thyroid Tumors With GLP-1 Receptor Agonists: A Retrospective Cohort Study
Daniel R Morales1, Fan Bu2, Benjamin Viernes3,4
1Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, U.K.
Diabetes Care
|June 4, 2025
Summary
Glucagon-like peptide 1 receptor agonist (GLP-1RA) use in type 2 diabetes patients did not increase thyroid tumor risk. This large study found no association between GLP-1RA exposure and thyroid tumors compared to other diabetes medications.
Area of Science:
- Endocrinology
- Pharmacology
- Oncology
Background:
- Glucagon-like peptide 1 receptor agonists (GLP-1RAs) are increasingly used for type 2 diabetes mellitus (T2DM).
- Concerns exist regarding potential associations between GLP-1RA use and thyroid tumors.
- This study investigates the risk of incident thyroid tumors in T2DM patients using GLP-1RAs.
Purpose of the Study:
- To assess the association between glucagon-like peptide 1 receptor agonist (GLP-1RA) use and the risk of incident thyroid tumors.
- To compare the risk of thyroid tumors in GLP-1RA users versus users of other second-line T2DM therapies.
Main Methods:
- Retrospective, active-comparator new-user cohort study utilizing international administrative claims and electronic health record databases.
- Included T2DM patients initiating GLP-1RAs versus sodium-glucose cotransporter 2 inhibitors (SGLT2is), dipeptidyl peptidase 4 inhibitors (DPP-4is), or sulfonylureas (SUs).
- Propensity score matching, Cox regression, and random-effects meta-analysis were employed to estimate hazard ratios (HRs).
Main Results:
- The study included over 460,000 GLP-1RA users and over 4.2 million users of comparator drugs.
- GLP-1RA exposure was not associated with an increased risk of thyroid tumors compared to SGLT2is, DPP-4is, or SUs.
- Meta-analysis revealed no significant increase in thyroid tumor risk across comparisons (e.g., GLP-1RA vs. SGLT2i HR range: 0.83-0.95).
Conclusions:
- No increased risk of thyroid tumors was observed with GLP-1RA exposure in patients with T2DM initiating second-line treatments.
- Findings suggest GLP-1RAs are a safe option regarding thyroid tumor risk in this patient population.
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