Weight-loss drugs like liraglutide may fight cancer independently of shedding pounds, possibly offering more protection than surgery, new research suggests.
After adjusting for the weight
loss benefits of surgery, GLP-1 drugs were linked to a 41% lower risk of
obesity-related cancer.
New research presented at the European Congress on
Obesity (ECO) in Malaga, Spain, and published in the journal eClinicalMedicine, suggests that some widely used
weight-loss medications may do more than just help people slim down.
First-generation drugs like liraglutide and exenatide appear to offer powerful
protection against certain types of cancer linked to obesity.
“Our
study found a similar incidence of obesity-related cancer among patients
treated with first-generation glucagon-like peptide-1 receptor agonists
(GLP-1s) and with bariatric surgery over an average of 8 years follow-up,
despite the relative advantage of surgery in maximizing weight loss,” explained
co-lead author Dr Yael Wolff Sagy from Clalit Health Services, Tel-Aviv,
Israel. “But accounting for this advantage revealed the direct effect of
GLP-1RAs beyond weight-loss to be 41% more effective at preventing
obesity-related cancer.”
She
adds: “We do not yet fully understand how GLP-1s work, but this study adds to
the growing evidence showing that weight loss alone cannot completely account
for the metabolic, anti-cancer, and many other benefits that these medications
provide.”
GLP-1
receptor agonists, or GLP-1RAs, are best known for helping manage type 2
diabetes and support weight loss. These medications work by mimicking a natural
hormone in the body that helps lower blood sugar and keeps people feeling fuller
for longer.
Both
obesity and diabetes are linked with an increased risk for many types of
cancer, referred as obesity related cancer, including post-menopausal breast
cancer, colorectal cancer, corpus uteri cancer, meningioma, renal-cell kidney,
liver or bile duct, pancreatic, thyroid, stomach, and ovarian cancer, as well
as multiple myeloma.
First-generation
GLP-1s and bariatric surgery are well-established weight loss treatments, but
their comparative effectiveness for the prevention of obesity-related cancers
is not known.
Large-Scale
Study With Long-Term Follow-Up
To find out more, researchers analyzed electronic health record data for patients (aged 24 years or older) with obesity (BMI of 35 kg/m2 or higher) and type 2 diabetes (with no prior history of cancer), who were treated with first-generation GLP-1s (i.e., for a minimum of six monthly purchases of liraglutide, exenatide, or dulaglutide within 12 consecutive months) or with bariatric surgery between 2010 and 2018 from Clalit health services—which insures over half of the Israeli population (approximately 4.8 million patients).
They found that GLP1-RAs had a direct effect on reducing obesity-related cancer beyond weight-loss, with a 41% lower relative risk compared to bariatric surgery.
“The protective effects of GLP1-RAs against obesity-related cancers likely arise from multiple mechanisms, including reducing inflammation,” said co-lead author Professor Dror Dicker from Hasharon Hospital, Rabin Medical Center, Petah Tikva, Israel. “Our study is unique in that the long-term follow-up allowed us to compare the effects of GLP1-RAs and surgery with potential long latency periods of cancer. New generation, highly potent GLP1-RAs with higher efficacy in weight reduction may convey an even greater advantage in reducing the risk of obesity-related cancers, but future research is needed to make sure that these drugs do not increase the risk for non–obesity-related cancers.”
Despite the important findings, the authors note that this is an observational study and that future randomized trials and larger prospective studies are needed to confirm the effects and explore the underlying mechanisms.
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