葡萄糖类1受体激素的使用和甲状腺癌的风险:斯堪的纳维亚队列研究
Björn Pasternak1,2, Viktor Wintzell1, Anders Hviid2,3
1Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
概括
在一个大规模的斯堪的纳维亚研究中,葡萄糖类1 (GLP1) 受体激活剂没有显示甲状腺癌的风险增加. 这一发现为使用这些糖尿病药物的患者提供了保证.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 药物监督 药物监督 药物监督
背景情况:
- 葡萄糖类1 (GLP1) 受体激动剂广泛用于2型糖尿病管理.
- 人们对使用GLP1受体激动剂与甲状腺癌风险之间存在潜在关联表示担忧.
- 需要强有力的现实世界的证据来评估这种关联.
研究的目的:
- 调查使用葡萄糖类1 (GLP1) 受体激动剂与患甲状腺癌的风险之间的关联.
- 为了比较启动GLP1受体激动剂的患者与启动二二酶4 (DPP4) 抑制剂或-葡萄糖共传输体2 (SGLT2) 抑制剂的患者的甲状腺癌风险.
主要方法:
- 使用来自丹麦,挪威和瑞典 (2007-2021) 的全国数据进行了斯堪的纳维亚队列研究.
- 一项活性对比新用户研究设计将开始使用GLP1受体激动剂的患者与开始使用DPP4抑制剂 (初级分析) 和SGLT2抑制剂 (二级分析) 的患者进行了比较.
- 考克斯回归与倾向性得分权重被用于估计危险比率,控制混因素.
主要成果:
- 这项研究包括大量的患者开始使用GLP1受体激素 (145,410) 和DPP4抑制剂 (291,667).
- 与使用DPP4抑制剂相比,使用GLP1受体激活剂与甲状腺癌的风险增加无关 (HR 0.93,95% CI 0.66-1.31).
- 在对比GLP1受体激活剂与SGLT2抑制剂的二次分析中,没有观察到甲状腺癌的实质性增加风险 (HR 1.16,95% CI 0.65-2.05).
结论:
- 在一项大型的全国性队列研究中,使用GLP1受体激动剂与甲状腺癌风险显著增加无关.
- 这些发现表明,GLP1受体激动剂可以安全地用于甲状腺癌风险.
- 置信区间的上限表明相对于DPP4抑制剂相比,相对风险增加不超过31%.
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