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

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.