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GLP-1 Receptor Agonist Exposure and Malignancy Risk in Patients With Endogenous Cushing's Syndrome.
Idit Dotan1,2, Tzipora Shochat3, Shiri Kushnir4
1Institute of Endocrinology, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) do not increase cancer risk in patients with Cushing's syndrome (CS), a population with a known higher risk of malignancy. This study found no association between GLP-1RA use and incident cancer in CS patients.
Area of Science:
- Endocrinology
- Oncology
- Pharmacology
Background:
- Patients with endogenous Cushing's syndrome (CS) face an elevated risk of developing malignancies.
- Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely prescribed for diabetes and obesity.
- Limited data exists on the oncologic safety of GLP-1RAs in CS patients.
Purpose of the Study:
- To investigate the association between exposure to GLP-1 receptor agonists (GLP-1RAs) and the incidence of new cancers in patients diagnosed with endogenous Cushing's syndrome (CS).
Main Methods:
- A nationwide cohort study was conducted using data from Israel's Clalit Health Services database (2000-2023).
- Patients with endogenous CS (excluding adrenal carcinoma or ectopic CS) were included.
- GLP-1RA exposure was defined by at least three prescription dispensations and analyzed as a time-varying variable.
Main Results:
- The study included 609 CS patients, with 137 (22.5%) receiving GLP-1RA therapy.
- Cancer incidence rates were 12.50 per 1,000 person-years in non-exposed and 17.59 per 1,000 person-years in GLP-1RA-exposed patients.
- Time-varying competing-risk analysis revealed no significant association between GLP-1RA exposure and increased malignancy risk (adjusted HR 1.22; 95% CI, 0.45-3.29).
Conclusions:
- In patients with Cushing's syndrome, GLP-1RA use was not linked to a higher risk of developing cancer.
- These findings suggest that GLP-1RAs are oncologically safe for use in the CS population.
- The study provides reassuring evidence for clinicians managing CS patients who may benefit from GLP-1RA therapy.
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