GLP-1 RAs Tied to Higher Thyroid Cancer Risk in First Year of Treatment
By Lori Solomon HealthDay Reporter
THURSDAY, Jan. 30, 2025 -- The absolute risk for thyroid cancer is low among patients receiving glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy, but risk is elevated in the first year of treatment, according to a study published online Jan. 23 in JAMA Otolaryngology-Head & Neck Surgery.
Juan P. Brito, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues estimated the risk for incident thyroid cancer among adults with type 2 diabetes being treated with GLP-1 RAs versus other common glucose-lowering medications. The analysis included 41,112 patients starting treatment with GLP-1 RAs; 76,093 starting a dipeptidyl peptidase-4 inhibitor (DPP4i); 43,499 starting a sodium-glucose cotransporter 2 inhibitor (SGLT2i); and 191,209 starting sulfonylurea therapy.
The researchers found that the numbers of patients diagnosed with thyroid cancer were 0.17 percent in the GLP-1 RA group, 0.23 percent in the DPP4i group, 0.17 percent in the SGLT2i group, and 0.20 percent in the sulfonylurea group. GLP-1 RA initiation was not significantly associated with an increased overall risk for thyroid cancer versus the other diabetes drugs in the modified intention-to-treat analysis (hazard ratio [HR], 1.24; 95 percent confidence interval [CI], 0.88 to 1.76). In the first year after GLP-1 RA initiation, thyroid cancer risk was elevated (HR, 1.85; 95 percent CI, 1.11 to 3.08) and was amplified in the overall as-treated analysis that restricted patients from analysis when therapy was discontinued or another medication was added (HR, 2.07; 95 percent CI, 1.10 to 3.95).
"These findings indicate that GLP-1 RA initiation was associated with new diagnosis of thyroid cancer only in the short term, likely due to increased vigilance and case detection rather than de novo pathogenesis," the authors write.
Several authors disclosed ties to relevant organizations.
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Posted January 2025
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