Thyroid Cancer Risk in Patients With Type 2 Diabetes Taking Glucagon‐Like Peptide 1 Receptor Agonists

Abstract Objective Glucagon‐like peptide 1 receptor agonists (GLP‐1RA) have shown remarkable results in glycemic control for patients with type 2 diabetes (T2DM). While no association has been made, there is a concern for thyroid cancer (TC) from GLP‐1RA. We aimed to study the 5‐year risk of TC in T2DM patients taking GLP‐1RA. Study Design Retrospective cohort. Setting TriNetX database. Methods TriNetX was queried to identify T2DM patients between 2017 and 2019. The 5‐year risk of TC in patients using GLP‐1RA was compared to patients taking sodium‐glucose cotransporter 2 inhibitors (SGLT‐2I), metformin, and dipeptidyl peptidase 4 inhibitors (DPP‐4I) after propensity score matching by demographics and comorbidities. Results On analysis of T2DM patients taking GLP‐1RA compared to SGLT‐2I, 7736 patients were in each cohort after matching. The 5‐year rate of TC in patients taking GLP‐1RA was 0.30% compared to 0.48% in those taking SGLT‐2I (RR 0.62 (95% CI 0.37‐1.05); P = .07). Analysis of GLP‐1RA versus metformin yielded 5158 patients in each cohort. Patients taking GLP‐1RA had similar rates of TC compared to those taking metformin (0.25% vs 0.39%; RR 0.65 (95% CI 0.32‐1.31); P = .22). A comparison of GLP‐1RA versus DPP‐4I yielded 12,570 patients in each cohort. The rate of TC was not increased in those taking GLP‐1RA compared to those taking DPP‐4I (0.33% vs 0.37%; RR 0.91 (0.60‐1.39); P = .67). Conclusion T2DM patients taking GLP‐1RA may not have an increased 5‐year risk of TC compared to those taking metformin, SGLT‐2I, or DPP‐4I. Conclusions of long‐term use are limited as most GLP‐1RA were approved within the last decade.