胰高血糖素样肽-1 受体激动剂相关癌症风险的差异：真实世界数据库分析。

Differential Risk of Cancer Associated with Glucagon-like Peptide-1 Receptor Agonists: Analysis of Real-world Databases.

机构信息

Department of Internal Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.

Division of Hospital Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.

出版信息

Endocr Res. 2022 Feb;47(1):18-25. doi: 10.1080/07435800.2021.1955255. Epub 2021 Aug 30.

DOI:10.1080/07435800.2021.1955255

PMID:34459679

Abstract

BACKGROUND

Glucagon-like peptide 1 receptor agonists (GLP1Ra) are commonly used in type 2 diabetes mellitus (T2DM). However, differential risk of various cancers among GLP1Ra recipients is unknown.

METHODS

We inquired an aggregated electronic health record database, Explorys, and compared the adjusted odds ratio (aOR) of cancers between GLP1Ra and metformin users. Findings were validated in the FDA Adverse Event Reporting System (FDA FAERS).

RESULTS

From 1/2005 to 6/2019, we identified 619 340 and 64 230 patients in the metformin and GLP1Ra group, respectively. Within 5 years of starting antidiabetic medications, GLP1Ra was associated with significantly lower incident risk of prostate (aOR 0.81, = .03), lung (aOR 0.81, = .05), and colon cancer (aOR 0.85, = .03), while the risk of thyroid cancer was significantly higher (aOR 1.65, < .01). Similar findings were seen in the FDA FAERS database, where GLP1Ra was associated with lower risk of prostate (aOR 0.72, = .08), lung (aOR 0.52, < .01), colon cancer (aOR 0.82, = .31), and higher risk of thyroid cancer (aOR 4.33, < .01). In addition, with longer duration of GLP1Ra use, the risk of prostate, lung, and colon cancer further decreased, suggesting an exposure duration-response relationship.

CONCLUSIONS

GLP1Ra is associated with lower risks of prostate, lung, and colon cancer, but higher risk of thyroid cancer.

摘要

背景

胰高血糖素样肽 1 受体激动剂（GLP1Ra）常用于 2 型糖尿病（T2DM）。然而，GLP1Ra 受者的各种癌症风险差异尚不清楚。

方法

我们查询了一个聚合电子健康记录数据库（Explorys），比较了 GLP1Ra 和二甲双胍使用者的癌症调整后比值比（aOR）。研究结果在 FDA 不良事件报告系统（FDA FAERS）中得到验证。

结果

从 2005 年 1 月至 2019 年 6 月，我们分别在二甲双胍组和 GLP1Ra 组中识别出 619340 例和 64230 例患者。在开始使用抗糖尿病药物的 5 年内，GLP1Ra 与前列腺癌（aOR 0.81， =.03）、肺癌（aOR 0.81， =.05）和结肠癌（aOR 0.85， =.03）的发病风险显著降低，而甲状腺癌的风险显著升高（aOR 1.65， <.01）。在 FDA FAERS 数据库中也观察到了类似的结果，其中 GLP1Ra 与前列腺癌（aOR 0.72， =.08）、肺癌（aOR 0.52， <.01）、结肠癌（aOR 0.82， =.31）的发病风险降低，而甲状腺癌的发病风险升高（aOR 4.33， <.01）。此外，随着 GLP1Ra 使用时间的延长，前列腺癌、肺癌和结肠癌的发病风险进一步降低，提示存在暴露时间-反应关系。