Center for Science, Health, and Society, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA.
Nat Med. 2024 Jan;30(1):168-176. doi: 10.1038/s41591-023-02672-2. Epub 2024 Jan 5.
Concerns over reports of suicidal ideation associated with semaglutide treatment, a glucagon-like peptide 1 receptor (GLP1R) agonist medication for type 2 diabetes (T2DM) and obesity, has led to investigations by European regulatory agencies. In this retrospective cohort study of electronic health records from the TriNetX Analytics Network, we aimed to assess the associations of semaglutide with suicidal ideation compared to non-GLP1R agonist anti-obesity or anti-diabetes medications. The hazard ratios (HRs) and 95% confidence intervals (CIs) of incident and recurrent suicidal ideation were calculated for the 6-month follow-up by comparing propensity score-matched patient groups. The study population included 240,618 patients with overweight or obesity who were prescribed semaglutide or non-GLP1R agonist anti-obesity medications, with the findings replicated in 1,589,855 patients with T2DM. In patients with overweight or obesity (mean age 50.1 years, 72.6% female), semaglutide compared with non-GLP1R agonist anti-obesity medications was associated with lower risk for incident (HR = 0.27, 95% CI = 0.200.32-0.600.36) and recurrent (HR = 0.44, 95% CI = 0.32-0.60) suicidal ideation, consistent across sex, age and ethnicity stratification. Similar findings were replicated in patients with T2DM (mean age 57.5 years, 49.2% female). Our findings do not support higher risks of suicidal ideation with semaglutide compared with non-GLP1R agonist anti-obesity or anti-diabetes medications.
对与司美格鲁肽治疗相关的自杀意念报告的担忧，司美格鲁肽是一种用于 2 型糖尿病 (T2DM) 和肥胖症的胰高血糖素样肽 1 受体 (GLP1R) 激动剂药物，已引起欧洲监管机构的调查。在这项来自 TriNetX 分析网络的电子健康记录的回顾性队列研究中，我们旨在评估与非 GLP1R 激动剂抗肥胖或抗糖尿病药物相比，司美格鲁肽与自杀意念的关联。通过比较倾向评分匹配的患者组，计算了 6 个月随访时新发和复发性自杀意念的风险比 (HR) 和 95%置信区间 (CI)。研究人群包括 240618 名超重或肥胖患者，他们被开处司美格鲁肽或非 GLP1R 激动剂抗肥胖药物，在 1589855 名 T2DM 患者中复制了这些发现。在超重或肥胖患者中（平均年龄 50.1 岁，72.6%为女性），与非 GLP1R 激动剂抗肥胖药物相比，司美格鲁肽与新发（HR=0.27，95%CI=0.200.32-0.600.36）和复发性（HR=0.44，95%CI=0.32-0.60）自杀意念的风险较低，在性别、年龄和种族分层中均一致。在 T2DM 患者中也复制了类似的发现（平均年龄 57.5 岁，49.2%为女性）。我们的研究结果不支持与非 GLP1R 激动剂抗肥胖或抗糖尿病药物相比，司美格鲁肽与自杀意念风险增加有关。
