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Meta-Analysis
. 2019 Jul 16:2019:1534365.
doi: 10.1155/2019/1534365. eCollection 2019.

Risk of Malignant Neoplasia with Glucagon-Like Peptide-1 Receptor Agonist Treatment in Patients with Type 2 Diabetes: A Meta-Analysis

Yufang Liu  1 , Xiaomei Zhang  1 , Sanbao Chai  1 , Xin Zhao  1 , Linong Ji  2
Affiliations
Meta-Analysis

Risk of Malignant Neoplasia with Glucagon-Like Peptide-1 Receptor Agonist Treatment in Patients with Type 2 Diabetes: A Meta-Analysis

Yufang Liu et al. J Diabetes Res. .

Abstract

Background: Glucagon-like peptide-1 (GLP-1) receptor agonists are effective glucose-lowering drugs, but there is concern that they may increase the risk of malignant neoplasia. The present meta-analysis examined the safety of GLP-1 receptor agonists with regard to malignant neoplasia.

Methods: We analyzed data from randomized controlled trials with a minimum duration of 24 weeks that assessed the incidence of neoplasms in type 2 diabetes patients receiving GLP-1 receptor agonists compared with placebo or other hypoglycemic drugs. We searched the MEDLINE, Embase, and Cochrane databases with a language restriction of English through October 1, 2018, and carried out a meta-analysis of the available trial data using a fixed effects model to calculate odds ratios (ORs) for neoplasia.

Results: Thirty-four relevant articles, providing data for 50452 patients, were included in the meta-analysis. Compared with the incidence of malignant neoplasia with placebo or other interventions, no increase in malignant neoplasm formation was observed with the use of GLP-1 receptor agonists (OR 1.04, 95% confidence interval (CI) 0.94-1.15; p = 0.46), liraglutide (OR 1.08, 95% CI 0.91-1.27; p = 0.38), exenatide (OR 1.00, 95% CI 0.86-1.16; p = 1.00), semaglutide (OR 0.89, 95% CI 0.35-2.22; p = 0.80), or albiglutide (OR 1.07, 95% CI 0.23-4.88; p = 0.93). A subanalysis of trials lasting longer than 3 years also showed no increase in the neoplasia risk with GLP-1 receptor agonist use (OR 1.03, 95% CI 0.92-1.15; p = 0.60). Between-trial statistical heterogeneity was low for all comparisons.

Conclusion: GLP-1 receptor agonists can be used without safety concerns related to malignant neoplasia in patients with type 2 diabetes.

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Conflict of interest statement

All authors have no conflicts of interest.

Figures

Figure 1
Figure 1
Study selection.
Figure 2
Figure 2
Meta-analysis of the incidence of neoplasms with the use of all tested GLP-1 receptor agonists versus placebo or other antidiabetic treatments.
Figure 3
Figure 3
Funnel plot for the comparison of the incidence of neoplasia with the use of GLP-1 receptor agonists versus placebo or other antidiabetic treatments.
Figure 4
Figure 4
Meta-analysis of the incidence of neoplasms with the use of specific GLP-1 receptor agonists versus placebo or other antidiabetic treatments.
Figure 5
Figure 5
Meta-analysis of the incidence of neoplasia with placebo versus GLP-1 receptor agonists used.
Figure 6
Figure 6
Meta-analysis of the incidence of neoplasia with the use of a GLP-1 receptor agonist versus placebo or other antidiabetic treatments, based on studies with a minimum duration of 3 years.
See this image and copyright information in PMC

References

    1. Marso S. P., Daniels G. H., Brown-Frandsen K., et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. The New England Journal of Medicine. 2016;375(4):311–322. doi: 10.1056/NEJMoa1603827. - DOI - PMC - PubMed
    1. Gier B., Matveyenko A. V., Kirakossian D., Dawson D., Dry S. M., Butler P. C. Chronic GLP-1 receptor activation by exendin-4 induces expansion of pancreatic duct glands in rats and accelerates formation of dysplastic lesions and chronic pancreatitis in the KrasG12D mouse model. Diabetes. 2012;61(5):1250–1262. doi: 10.2337/db11-1109. - DOI - PMC - PubMed
    1. Bjerre Knudsen L., Madsen L. W., Andersen S., et al. Glucagon-like peptide-1 receptor agonists activate rodent thyroid C-cells causing calcitonin release and C-cell proliferation. Endocrinology. 2010;151(4):1473–1486. doi: 10.1210/en.2009-1272. - DOI - PubMed
    1. Elashoff M., Matveyenko A. V., Gier B., Elashoff R., Butler P. C. Pancreatitis, pancreatic, and thyroid cancer with glucagon-like peptide-1-based therapies. Gastroenterology. 2011;141(1):150–156. doi: 10.1053/j.gastro.2011.02.018. - DOI - PMC - PubMed
    1. Egan A. G., Blind E., Dunder K., et al. Pancreatic safety of incretin-based drugs--FDA and EMA assessment. The New England Journal of Medicine. 2014;370(9):794–797. doi: 10.1056/NEJMp1314078. - DOI - PubMed

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