Drugs like Ozempic were not associated with any significant increase in thyroid cancer risk in a recent study from researchers in Sweden.
- Glucagon-like peptide-1 (GLP-1) receptor
agonists are a class of drugs used to control blood glucose (sugar) levels
in people with type 2 diabetes.
- Doctors also prescribe them for people with
obesity or overweight with related health conditions, to help them lose
weight.
- Early studies suggested that GLP-1 receptor
agonists might increase the risk of thyroid cancer.
- Now, a large-scale Scandinavian study has found
no significant increase in thyroid cancer risk in those taking GLP-1
receptor agonists compared with those on other treatments for type 2
diabetes.
Glucagon-like peptide-1 receptor (GLP-1) agonists are
an effective treatment for controlling blood glucose levels in people with type 2
diabetes, particularly those who do not respond, or stop responding to,
first-line treatments, such as
There are many versions of GLP-1 drugs, including:
liraglutide (Victoza), which people inject daily- semaglutide
(Rybelsus), an oral
tablet which people take once daily
dulaglutide (Trulicity), which people inject once a week- semaglutide
(Ozempic/ Wegovy), which people
inject once a week
exenatide (Bydureon), which people inject once a week.
They work by increasing the release of insulin —
the hormone that controls blood glucose by moving it into cells — and
suppressing the release of glucagon,
which releases glucose from the liver into the blood.
Clinicians also prescribe the drugs for weight loss in people without type 2
diabetes. Both the
Use of
GLP-1 agonists has increased greatly since they were first approved. One
concern about the medications, however, is that
Now, a large-scale study has found no significant
increase in thyroid cancer risk for people with type 2 diabetes on GLP-1
agonists compared with people treated with
The study appears in
Björn Pasternak, MD, PhD,
lead author, and principal researcher at the Department of Medicine, Solna, at Karolinska
Institutet in Sweden, explained why the team conducted the the study.
“Many people take these medicines, so it is important
to study potential risks associated with them,” he noted in a press release.
“Our
study covers a broad group of patients and provides strong support that GLP-1
analogues are not associated with an increased risk of thyroid cancer,” he
added.
This large cohort study used data on more than 145,000
people treated with GLP-1 agonists, and almost 292,000 people treated with DPP4
inhibitors from Norway, Sweden and Denmark.
The GLP-1 agonists used were liraglutide (57.3%),
followed by semaglutide (32.9%), dulaglutide (4.9%), exenatide (4.1%), and
lixisenatide (0.9%).
The researchers followed up participants after a mean
of 3.9 years for the GLP-1 group and 5.4 years for the DPP4 group.
They identified cases of thyroid cancer from
nationwide cancer registers. In the GLP-1 group, 76 of 145, 410 people
developed thyroid cancer, and in the DPP4 group, 184 of 291, 667 developed the
disease.
From
these data, the researchers worked out that the relative risk was increased by
no more than 31% for those on GLP-1 agonists.
Mir Ali, MD, bariatric surgeon and medical
director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical
Center in Fountain Valley, CA, not involved in this research, explained what
this means for people taking GLP-agonists.
He told Medical News Today that:
“The meaning of relative
risk is the risk compared to someone not taking the medication — 31% is very
low and indicates that the risk of developing thyroid cancer due to this
medication is relatively low.”
Nevertheless, “[c]aution still needs to be taken in
patients who fall into the category of hereditary thyroid cancers — like
multiple endocrine neoplasia syndromes,” he added.
Thyroid cancer is more common in women than in men, but is
still a relatively rare form of cancer. The
GLP-1 agonists have other health benefits, alongside
controlling blood glucose and weight loss. Studies have shown that they have cardiovascular benefits, particularly in
people with obesity.
Other
A recent study found that they may also help
delay the progression of chronic kidney disease, which often develops in people
with type 2 diabetes.
People should be aware that there are
- gastrointestinal
symptoms, such as nausea, vomiting, diarrhea and abdominal pain
- irritation/inflammation
at the injection site.
Ali told MNT that the study
should reassure people, since previous concerns about thyroid cancer risk were
from animal studies, adding: “I think this study can help reassure patients
taking these medications that they are safe and risk of thyroid cancer is very
low.”
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