Risk of Thyroid Tumors With GLP-1 Receptor Agonists: A Retrospective Cohort Study
Authors' conclusion
In patients with T2DM initiating second-line treatments, we observed no increased risk of thyroid tumors with GLP-1RA exposure.
Study context
- Population
- Patients with T2D with prior metformin therapy initiating a GLP-1 RA vs new users of SGLT2i, DPP-4i or SUonly U.S
- Participants
- 460,032 / 717,792 / 2,055,583 / 1,119,868
- Exposure
- GLP-1 RA vs SGLT2i, DPP-4i and SU
- GLP-1RAn = 460,032
- SGLT2in = 717,792reference
- DPP-4in = 2,055,583reference
- SUn = 1,119,868reference
- Outcome
- Incident thyroid tumor and thyroid malignancy
Methodological detailsactive-comparator new-user, international administrative claims and electronic health record databases, propensity score matching and stratification, random-effects meta-analysis
- Active-comparator new-user
- International administrative claims and electronic health record databases
- Propensity score matching and stratification
- Random-effects meta-analysis
Main finding
As reported in the abstract
Thyroid tumors
HR range
0.83 to 0.95
95% CI 0.57–1.27; 0.85–1.06
GLP-1RA vs SGLT2i
HR range
0.95 to 1.03
95% CI 0.75–1.20; 0.87–1.23
GLP-1RA vs SU
HR range
0.78 to 0.93
95% CI 0.60–1.01; 0.83–1.04
GLP-1RA vs DPP-4i
GLP-1RA
0.88 to 1.03 per 1,000 person-years
Observational data: associations, not effects.
Further findings
Thyroid malignancy; 1-year lag period
- Similar conclusions
Original publication
Risk of Thyroid Tumors With GLP-1 Receptor Agonists: A Retrospective Cohort Study. Diabetes Care. Published 4 June 2025. doi:10.
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