Glucagon-Like Peptide-1 Receptor Agonists and Pancreatic Cancer Risk in Patients With Type 2 Diabetes
Main finding · Pancreatic cancer, per incremental 1 defined daily dose per dayResult — go to the resultHazard ratio 0.50 95% CI 0.15–1.71Authors' conclusion
In this historical cohort study of adults with type 2 diabetes, no support for an increased pancreatic cancer incidence over 7 years following start of GLP-1RA treatment was found. However, monitoring for pancreatic cancer risk beyond 7 years following initiation of therapy is still required.
Study context
- Population
- Adults aged 21 to 89 years with T2D insured by Clalit Healthcare Services, Israel, followed from 2009 to December 2017; mean (SD) age 59.9 (12.8) years, 51% women
- Participants
- 543,595 adults3,290,439 person-years
- Exposure
- GLP-1 RA vs basal insulin
- GLP-1RAn = 33,377
- Basal insulinn = 106,849reference
- Outcome
- Pancreatic cancer incidence by weighted cumulative exposure to GLP-1 RA vs basal insulin
- Follow-up
- Fifth to seventh year after medication
Methodological detailsweighted cumulative exposure Cox model in discrete time, adjusted for confounding
- Weighted cumulative exposure Cox model in discrete time
- Adjusted for confounding
Main finding
As reported in the abstract
Pancreatic cancer, per incremental 1 defined daily dose per day · fifth to seventh year previously
Hazard ratio
0.50
95% CI 0.15–1.71
GLP-1RAvs Basal insulin
HR 0.50 (95% CI 0.15–1.71)
- Pancreatic cancer diagnoses (whole cohort)
- 1665
Observational data: associations, not effects.
Further findings
| Outcome | HR (95 % CI) | |
|---|---|---|
| Pancreatic cancer, sensitivity analyses (from fifth year after initiation) · fifth year onwardsGLP-1RAvs Basal insulinPropensity score-matched new-user design | 0.52 (0.19–1.41) | |
| Pancreatic cancer, sensitivity analyses (from fifth year after initiation) · fifth year onwardsGLP-1RAvs Basal insulinPrevalent new-user design | 0.75 (0.37–1.53) | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Glucagon-Like Peptide-1 Receptor Agonists and Pancreatic Cancer Risk in Patients With Type 2 Diabetes. JAMA Netw Open. Published 2 January 2024. doi:10.
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