Association of glucagon-like peptide-1 receptor agonists with suicidal ideation and self-injury in individuals with diabetes and obesity: a propensity-weighted, population-based cohort study
Main finding · SISResult — go to the resultHazard ratio 1.04 95% CI 0.35–3.14Authors' conclusion
Our findings do not support an increased risk of SIS when taking GLP-1RA in individuals with type 2 diabetes and obesity; however, the rarity of SIS events and the wide uncertainty of effect size (although null, effect may be compatible with a risk as high as threefold) calls for a cautious interpretation of our results. Further studies, including final evaluations from regulatory bodies, are called for to discard a causal link between GLP-1RA and suicidality.
Study context
- Population
- Adults with obesity initiating GLP-1 RA or SGLT2i for T2D, 2015–2021, Spanish population of five million inhabitants
- Participants
- 3,040 vs 11,627
- Exposure
- GLP-1 RA vs SGLT2i
- GLP-1RAn = 3,040
- SGLT-2in = 11,627reference
- Outcome
- Suicidal ideation and self-injury (SIS)
Methodological detailsnew user, active comparator design, inverse probability of treatment weighting based on propensity scores
- New user, active comparator design
- Inverse probability of treatment weighting based on propensity scores
Main finding
SIS
Hazard ratio
1.04
95% CI 0.35–3.14
As reported in the abstract
Observational data: associations, not effects.
Further findings
SIS, ITT analysis
- HR (ITT analysis)
- 1.36 (95% CI 0.51, 3.61)
- Intention-to-treat
SIS, sensitivity analysis excluding individuals with no BMI information
- HR (excluding no BMI information)
- 0.89 (95% CI 0.26, 3.14)
SIS, sensitivity analysis with imputation for BMI missing values
- HR (imputation for BMI missing values)
- 1.29 (95% CI 0.42, 3.92)
SIS, stratified analyses
- Stratified analyses showed no differences between subgroups
Original publication
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