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Cited by 35Diabetes Treatment and ManagementPancreatic and Hepatic Oncology ResearchMetabolism, Diabetes, and Cancer

Exenatide use and incidence of pancreatic and thyroid cancer: A retrospective cohort study

Liang, Caihua, Bertoia, Monica L., Ding, Yan, Clifford, C. Robin, Qiao, Qing, Gagne, Joshua J., Dore, David D.·2019·Diabetes, Obesity and Metabolism
DOI 10.1111/dom.13597
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Abstract

A retrospective cohort study, supplemented with a nested case-control study, was performed using two administrative databases from commercial health plans in the United States to compare the incidence of pancreatic and thyroid cancer among users of exenatide versus other antidiabetic drugs (OADs). Patients with type 2 diabetes who initiated exenatide or OADs between 1 June 2005 and 30 June 2015 were included. Pancreatic and thyroid cancers were identified using chart-validated algorithms in the cohort study. Cases in the nested case-control study were chart-confirmed pancreatic or thyroid cancers, and controls were sampled using risk-set sampling. The time-fixed analyses comparing 33 629 exenatide initiators with 49 317 propensity-score-matched OAD initiators yielded hazard ratios of 0.76 (95% confidence interval [CI] 0.47-1.21) for pancreatic cancer and 1.46 (95% CI 0.98-2.19) for thyroid cancer. Results in the time-dependent analyses by cumulative duration or dose were similar. Nested case-control analyses yielded rate ratios of 0.61 (95%CI, 0.37-1.00) for pancreatic cancer and 0.89 (95% CI, 0.64-1.24) for thyroid cancer. This observational study suggested exenatide use was not associated with an increased risk of pancreatic or thyroid cancer.

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Crossref · 10.1111/dom.13597

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  • In a cohort study of patients with type 2 diabetes starting exenatide or other agents between 2005 and 2015, exenatide use was associated with a hazard ratio for thyroid cancer of 1.46 (95% CI 0.98-2.19).

    “The cohort study included 33,629 patients who started exenatide and 49,319 propensity score–matched initiators of other agents with a median follow-up time of 0.9 years, and identified 57 cases of thyroid cancer in the exenatide group and 43 cases in the comparator group. The hazard ratio (HR) for thyroid cancer was 1.46 [CI 0.98–2.19].”

    From Glucagon-Like Peptide-1 Receptor Agonists and Thyroid Cancer: A Narrative Review (2024) · cites this paper as [53]

  • The potential for residual confounding and the role of surveillance bias are important considerations that have not been thoroughly assessed.

    “Similarly, the potential for residual confounding (e.g., limited evaluation of specific risk factors for thyroid cancer such as obesity, neck radiation, and family history of thyroid cancer) and the role of surveillance bias (e.g., clinicians might be more likely to do a thyroid exam or ultrasound on patients taking GLP-1 RA) are important considerations that have been not thoroughly assessed.25,”

    From Glucagon-Like Peptide-1 Receptor Agonists and Thyroid Cancer: A Narrative Review (2024) · cites this paper as [53]

  • Liang et al. developed and validated algorithms based on diagnosis and procedure codes for outcome assessment, with a positive predictive value of 88% for thyroid cancer without distinction between non-MTC and MTC.

    “For outcome assessment, authors developed and validated algorithms based on diagnosis and procedures codes, with a positive predictive value of 88% for thyroid cancer without distinction between non-MTC and MTC.53”

    From Glucagon-Like Peptide-1 Receptor Agonists and Thyroid Cancer: A Narrative Review (2024) · cites this paper as [53]

  • Five observational studies included analyses considering different lag times for outcome assessment, while two studies provided distinct information differentiating between thyroid cancer in general and MTC.

    “In addition, five studies included analyses considering different lag times for outcome assessment, while two studies provided distinct information differentiating between thyroid cancer in general and MTC.25,38,51–53”

    From Glucagon-Like Peptide-1 Receptor Agonists and Thyroid Cancer: A Narrative Review (2024) · cites this paper as [53]

  • In a nested case-control study, exenatide use was not associated with an increased risk for thyroid cancer (adjusted odds ratio = 0.89, 95% CI 0.64-1.24).

    “In the nested case–control study exenatide use was not associated with an increased for thyroid cancer (adjusted odds ratio [OR] = 0.89 [CI 0.64–1.24]).53”

    From Glucagon-Like Peptide-1 Receptor Agonists and Thyroid Cancer: A Narrative Review (2024) · cites this paper as [53]

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Authors
Liang, C., Bertoia, M. L., Ding, Y., Clifford, C. R., Qiao, Q., Gagne, J. J., & Dore, D. D.
Affiliations
  • Optum Epidemiology Boston Massachusetts
  • AstraZeneca (Sweden) (SE)
  • Brigham and Women's Hospital (US)
  • Brown University (US)
Corresponding author
Liang, Caihua
ORCID
Venue
Diabetes, Obesity and Metabolism
Publisher
Wiley
Published
2018-12-25
Volume
21
Issue
4
Pages
1037-1042
ISSN
  • 1462-8902 (ISSN-L)
  • 1463-1326
DOI
10.1111/dom.13597
OpenAlex
W2903241885
Cited by
35
References
16
Citations by year
2026: 5 · 2025: 10 · 2024: 6 · 2023: 3 · 2022: 4 · 2021: 1 · 2020: 3 · 2019: 3
FWCI
1.39
Type
journal article
Language
en
Update notices
correction (2020-04-01)
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Diabetes Obesity and Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Funders
AstraZeneca
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
Keywords
exenatide, pancreatic cancer, thyroid cancer, cancer incidence, type 2 diabetes, antidiabetic drugs, drug safety, GLP-1 receptor agonists, cancer risk
MeSH terms
Exenatide, Adult, Aged, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemic Agents, Male, Middle Aged, Pancreatic Neoplasms, Retrospective Studies, Thyroid Neoplasms, United States, Cohort Studies, Incidence, Proportional Hazards Models, Databases, Factual, Incretins, Propensity Score

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