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替尔泊肽与糖尿病患者和非糖尿病患者的癌症风险:一项系统评价和荟萃分析

Tirzepatide and Cancer Risk in Individuals with and without Diabetes: A Systematic Review and Meta-Analysis.

作者信息

Kamrul-Hasan A B M, Alam Muhammad Shah, Dutta Deep, Sasikanth Thanikai, Aalpona Fatema Tuz Zahura, Nagendra Lakshmi

机构信息

Department of Endocrinology, Mymensingh Medical College, Mymensingh, Bangladesh.

Department of Medicine, Army Medical College Cumilla, Cumilla, Bangladesh.

出版信息

Endocrinol Metab (Seoul). 2025 Feb;40(1):112-124. doi: 10.3803/EnM.2024.2164. Epub 2025 Jan 15.

Abstract

BACKGRUOUND

Data on the carcinogenic potential of tirzepatide from randomized controlled trials (RCTs) are limited. Furthermore, no meta-analysis has included all relevant RCTs to assess the cancer risk associated with tirzepatide.

METHODS

RCTs involving patients receiving tirzepatide in the intervention arm and either a placebo or any active comparator in the control arm were searched through electronic databases. The primary outcome was the overall risk of any cancer, and secondary outcomes were the risks of specific types of cancer in the tirzepatide versus the control groups.

RESULTS

Thirteen RCTs with 13,761 participants were analyzed. Over 26 to 72 weeks, the tirzepatide and pooled control groups had identical risks of any cancer (risk ratio, 0.78; 95% confidence interval, 0.53 to 1.16; P=0.22). The two groups had comparable cancer risks in patients with and without diabetes. In subgroup analyses, the risks were also similar in the tirzepatide versus placebo, insulin, and glucagon-like peptide-1 receptor agonist groups. The overall cancer risk was also comparable for different doses of tirzepatide compared to the control groups; only a 10-mg tirzepatide dose had a lower risk of any cancer than placebo. Furthermore, compared to the control groups (pooled or separately), tirzepatide did not increase the risk of any specific cancer types. Despite greater increments in serum calcitonin with 10- and 15-mg tirzepatide doses than with placebo, the included RCTs reported no cases of papillary thyroid carcinoma.

CONCLUSION

Tirzepatide use in RCTs over 26 to 72 weeks did not increase overall or specific cancer risk.

摘要

背景

来自随机对照试验(RCT)的有关替尔泊肽致癌潜力的数据有限。此外,尚无荟萃分析纳入所有相关RCT来评估与替尔泊肽相关的癌症风险。

方法

通过电子数据库检索干预组接受替尔泊肽且对照组接受安慰剂或任何活性对照剂的RCT。主要结局是任何癌症的总体风险,次要结局是替尔泊肽组与对照组中特定类型癌症的风险。

结果

分析了13项RCT,共13761名参与者。在26至72周期间,替尔泊肽组和汇总对照组的任何癌症风险相同(风险比,0.78;95%置信区间,0.53至1.16;P=0.22)。糖尿病患者和非糖尿病患者两组的癌症风险相当。在亚组分析中,替尔泊肽组与安慰剂组、胰岛素组和胰高血糖素样肽-1受体激动剂组的风险也相似。与对照组相比,不同剂量替尔泊肽的总体癌症风险也相当;只有10mg替尔泊肽剂量的任何癌症风险低于安慰剂。此外,与对照组(汇总或单独)相比,替尔泊肽不会增加任何特定癌症类型的风险。尽管10mg和15mg替尔泊肽剂量组的血清降钙素升高幅度大于安慰剂组,但纳入的RCT均未报告甲状腺乳头状癌病例。

结论

在26至72周的RCT中使用替尔泊肽不会增加总体或特定癌症风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0040/11898313/8aafa2c2e455/enm-2024-2164f1.jpg

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