GLP-1 Receptor Agonists Not Associated With Increased Thyroid Cancer Risk
Glucagon-like peptide-1 (GLP-1) therapy with liraglutide or semaglutide does not increase the risk for thyroid cancer among patients with type 2 diabetes or obesity/overweight, according to study findings published in Diabetes, Obesity and Metabolism.
GLP-1 receptor agonists effectively treat type 2 diabetes or overweight/obesity, but preclinical data in rodents suggest an increased risk for medullary thyroid cancer with GLP-1 use. In humans, however, the evidence has been mixed.
This new analysis included data from multiple sources: 93 phase 2 and 3 clinical trials (including 6 cardiovascular outcome trials) of liraglutide or semaglutide conducted between 2006 and 2024; postmarketing surveillance data from the Novo Nordisk safety database; and real-world data from the US Merative MarketScan Commercial Database.
In the clinical trials, which included a total of 101,732 participants with 207,045 patient-years of exposure, there were low numbers of thyroid cancer events (0.08% with GLP-1s, 0.06% with placebo, and 0.03% with active comparators). There were nonsignificant trends toward higher risks for thyroid cancer with GLP-1 drugs vs placebo (hazard ratio [HR], 1.70; 95% CI, 0.99-3.03) and active comparators (HR, 1.83; 95% CI, 0.70-6.71), potentially due to detection bias.