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GLP-1 receptor agonists and the risk of thyroid cancer

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posted on 2022-11-10, 18:52 authored by Julien Bezin, Amandine Gouverneur, Marine Pénichon, Clément Mathieu, Renaud Garrel, Dominique Hillaire-Buys, Antoine Pariente, Jean-Luc Faillie

  

Objective

To determine whether the use of GLP-1 receptor agonists (RA) is associated with an increased risk of thyroid cancer.

Research Design and Methods

A nested case-control analysis was performed using the French national healthcare insurance system database (SNDS). Individuals with type 2 diabetes treated with second-line antidiabetic drugs between 2006 and 2018 were included in the cohort. All thyroid cancers were identified through hospital discharge diagnoses and medical procedures between 2014 and 2018. Exposure to GLP-1 RA was measured within the 6 years preceding a 6-month lag-time period and considered as current use and cumulative duration of use based on defined daily dose (≤1, 1 to 3, >3 years). Cases were matched with up to 20 controls on age, sex, and length of diabetes, using the risk-set sampling procedure. The risk of thyroid cancer related to the use of GLP-1 RA was estimated using a conditional logistic regression adjusted on goiter, hypothyroidism, hyperthyroidism, other antidiabetic drugs and social deprivation index.

Results

2,562 cases of thyroid cancers were included in the study and matched to 45,184 controls. The use of GLP-1 RA for 1 to 3 years was associated with an increased risk of all thyroid cancer (adjusted hazard ratio: 1.58, 95% confidence interval: 1.27 to 1.95), and medullary thyroid cancer (aHR: 1.78, 95% CI: 1.04 to 3.05). 

Conclusions

The present study found an increased risk of all thyroid cancer and medullary thyroid cancer with the use of GLP-1 RA, in particular after 1 to 3 years of treatment.

Funding

This work was supported by the French Medicines Agency (Agence Nationale de Sécurité du Médicament et des Produits de Santé, ANSM; grant No 2019S015) in the context of a partnership with the Health Product Epidemiology Scientific Interest Group (EPI-PHARE). The present study is part of the Drugs Systematized Assessment in Real-life Environment (DRUGS-SAFER) research program. This program aims at providing an integrated system allowing the concomitant monitoring of drug use and safety in France. The potential impact of drugs, frailty of populations and seriousness of risks drive the research program. The French Medicines Agency played no role in the study design, conduct, and results interpretation or discussion. This publication represents the views of the authors and does not necessarily represent the opinion of the French Medicines Agency.

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