To assess the association between GLP-1 receptor agonist (GLP-1RA) use and incidence of hematologic malignancies in adults with type 2 diabetes, compared with DPP-4 inhibitors or SGLT2 inhibitors.
Approach:
Design and data: Retrospective propensity score–matched cohort study using the TriNetX electronic health record network. Adults initiating a GLP-1RA between January 2015 and March 2021 were compared with users of DPP-4 inhibitors and SGLT2 inhibitors.
Analysis: After 1:1 matching, analyses included 68,949 pairs for the DPP-4 inhibitor comparison and 71,391 pairs for the SGLT2 inhibitor comparison. Time-to-event outcomes were assessed from 180 days after treatment initiation through 5 years.
Key Findings:
Compared with DPP-4 inhibitors, GLP-1RAs were not associated with statistically significant differences in any assessed hematologic malignancy.
Compared with SGLT2 inhibitors, GLP-1RAs were associated with lower incidence of non-Hodgkin lymphoma (HR 0.82; 95% CI 0.68–0.99), myeloproliferative neoplasms (HR 0.78; 95% CI 0.67–0.91), and Hodgkin lymphoma (HR 0.52; 95% CI 0.30–0.91).
No significant differences were found for the other assessed malignancies in the SGLT2 inhibitor comparison or for exploratory non-Hodgkin lymphoma subtypes in either comparison.
Interpretation:
Associations between GLP-1RA use and hematologic malignancy incidence differed by active comparator: lower incidence of three outcomes was observed versus SGLT2 inhibitors, but not versus DPP-4 inhibitors.
Limitations:
The study was retrospective and based on electronic health records.
The provided article context ends before the authors’ full discussion of limitations.
Harold Burstein, MD, PhD, and Jennifer A. Ligibel, MD discuss new research from the Breast Cancer Weight Loss (BWEL) trial, as well as recommendations for lifestyle, diet and GLP1 agonists.
