Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, No. 139 Renmin Road, Changsha, 410011, Hunan, China.
Key Laboratory of Diabetes Immunology, Central South University, Ministry of Education, National Clinical Research Center for Metabolic Diseases, Changsha, China.
Endocrine. 2019 Nov;66(2):157-165. doi: 10.1007/s12020-019-02055-z. Epub 2019 Aug 16.
Some preliminary studies reported a link between GLP-1 receptor agonists (GLP-1RAs) and thyroid/pancreatic neoplasms, while its human relevance remained undetermined. The present meta-analysis was performed to collect information on cancers associated with GLP-1RAs in patients with type 2 diabetes mellitus (T2DM).
Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and ClinicalTrials.gov were extensively searched to identify randomized controlled trials that reported cancer events in T2DM patients treated with GLP-1RAs for at least 52 weeks, up to March 18, 2019. Odds ratio (OR) with 95% Confidence Interval (CI) was calculated for overall cancer (primary outcome), thyroid and pancreatic cancer.
A total of 37 eligible trials were identified. The OR for overall cancer associated with GLP-1RAs was 1.03 (95% CI 0.95-1.12; p = 0.41) compared with comparators. Subgroup analyses showed that treatment with albiglutide was associated with a lower risk of overall cancer (OR 0.76 [95% CI 0.60-0.97]; p = 0.03), and no elevated risk of overall cancer was identified for other GLP-1RAs. No significant differences in the risks of thyroid nor pancreatic cancer were disclosed between GLP-1RAs and comparators.
This meta-analysis did not suggest any increased risk of cancers associated with GLP-1RAs use in T2DM. The reduction in the risk of overall cancer associated with albiglutide needs to be examined further.
一些初步研究报告称 GLP-1 受体激动剂（GLP-1RAs）与甲状腺/胰腺肿瘤之间存在关联，但其与人类的相关性尚不确定。本荟萃分析旨在收集与 2 型糖尿病（T2DM）患者使用 GLP-1RAs 相关的癌症信息。
广泛检索 Medline、Embase、Cochrane 中央对照试验注册中心（CENTRAL）、Web of Science 和 ClinicalTrials.gov，以确定至少有 52 周的 T2DM 患者使用 GLP-1RAs 治疗并报告癌症事件的随机对照试验。计算总体癌症（主要结局）、甲状腺癌和胰腺癌的比值比（OR）及其 95%置信区间（CI）。
共纳入 37 项符合条件的试验。与对照相比，GLP-1RAs 与总体癌症相关的 OR 为 1.03（95%CI 0.95-1.12；p=0.41）。亚组分析显示，与其他 GLP-1RAs 相比，使用阿必鲁肽治疗与总体癌症风险降低相关（OR 0.76 [95%CI 0.60-0.97]；p=0.03），而其他 GLP-1RAs 并未增加总体癌症风险。GLP-1RAs 与对照相比，甲状腺癌和胰腺癌的风险无显著差异。
本荟萃分析未提示 GLP-1RAs 在 T2DM 中的应用与癌症风险增加相关。需要进一步研究阿必鲁肽降低总体癌症风险的作用。
