GLP-1RA的使用和甲状腺癌风险
Juan P Brito1,2, Jeph Herrin3, Kavya Sindhu Swarna4,5
1Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota.
JAMA otolaryngology-- head & neck surgery
|January 23, 2025
概括
类似葡萄糖-1受体激活剂 (GLP-1RA) 在2型糖尿病患者中没有显示整体增加甲状腺癌风险. 然而,在GLP-1RA使用的第一年内观察到更高的风险,可能是由于早期检测.
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受体激动剂 (GLP-1RA) 的广泛使用需要彻底了解它们与甲状腺癌的潜在关联.
- 现有的研究已经产生了关于GLP-1RA和甲状腺恶性瘤之间的联系的相互矛盾的结果.
研究的目的:
- 与其他常见的降糖药物相比,研究使用GLP-1RA治疗的2型糖尿病成年人发生甲状腺癌的风险.
- 分析GLP-1RA使用与甲状腺癌风险在治疗开始后的不同时间间隔之间的关联.
主要方法:
- 使用目标试验仿真方法对2014年1月1日至2021年12月31日的美国索赔数据进行二次分析.
- 包括患有2型糖尿病的成年人开始使用GLP-1RA,SGLT2抑制剂,DPP4抑制剂或硫尿素的治疗.
- 用反向倾向分数加权的Cox比例危险模型来估计甲状腺癌的危险比率 (HR).
主要成果:
- 该研究包括351,913名患者;41,112人开始GLP-1RA治疗.
- 与其他药物类别相比,GLP-1RA启动与甲状腺癌的总体风险增加没有显著关联 (HR,1.24;95% CI,0.88-1.76).
- 在GLP-1RA启动的第一年内,观察到甲状腺癌的风险显著增加 (HR,1.85;95% CI,1.11-3.08),在治疗分析中得到了放大.
结论:
- 虽然甲状腺癌的绝对风险仍然很低,但GLP-1RA治疗可能与使用第一年内新诊断甲状腺癌的风险增加有关.
- 这种早期增加的风险可能归因于对先前存在的或早期甲状腺癌的增强检测.
- 需要进一步的研究来阐明这种观察到的关联及其临床影响背后的机制.
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