CoChat
Sign Up
Cited by 28Pharmacovigilance and Adverse Drug ReactionsDiabetes Treatment and ManagementMetabolism, Diabetes, and Cancer

Incidence of health insurance claims for thyroid neoplasm and pancreatic malignancy in association with exenatide: signal refinement using active safety surveillance

Open access
Dore, David D., Seeger, John D., Chan, K. Arnold·2012·Therapeutic Advances in Drug Safety
DOI 10.1177/2042098612446473PMC PMC4110848
Open this paper in CoChat — free account

Abstract

OBJECTIVES: As part of a regulatory postmarketing commitment, we assessed the risk of claims for thyroid and pancreatic cancer among users of exenatide using an active drug safety surveillance system. METHODS: This active surveillance assessment used cohort methodology and commercial health insurance claims data to identify initiators of exenatide and propensity score-matched initiators of metformin or glyburide between June 2005 and September 2009, with up to 1 year of follow up through December 2009. The primary analysis estimated absolute and relative risk (RR) of inpatient or outpatient claims with diagnosis codes for thyroid neoplasm (benign or malignant) or pancreatic malignancies after exclusion of patients with a history of the same diagnosis at baseline. RESULTS: Among the matched comparison cohorts (N ≈ 32,800 each), there were 37 claims-suggested thyroid malignancies among exenatide initiators and 26 among metformin or glyburide initiators [RR 1.4; 95% confidence interval (CI) 0.8-2.4]. This association was attenuated when limited to inpatient thyroid cancer claims (RR 0.9; CI 0.3-2.6). Exenatide use was not associated with an increased risk of benign thyroid neoplasm (RR 0.7; CI 0.3-1.7), or pancreatic cancer (RR 0.8; CI 0.5-1.6). CONCLUSIONS: Use of exenatide was associated with a modestly higher incidence of inpatient and outpatient claims, but not inpatient claims for thyroid malignancies. Exenatide was not associated with higher risk of benign thyroid neoplasm or pancreatic cancer. Misclassification of outcomes and exposure, and residual confounding remain limitations of this analysis to be considered when interpreting the results. We have initiated a formal epidemiologic investigation to explore these relationships.

Integrity signals

Registry

Crossref · 10.1177/2042098612446473

Cites

15 of 15 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • 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 [52]

  • 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 [52]

  • Two observational studies and a study based on two U.S. administrative databases did not highlight a significant increased risk of thyroid cancer with exenatide.

    “Furthermore, two observational studies, as well as a study based on two U.S. administrative databases did not highlight a significant increased risk of thyroid cancer with exenatide [130,131].”

    From Adipose Tissue: A Novel Target of the Incretin Axis? A Paradigm Shift in Obesity-Linked Insulin Resistance (2024) · cites this paper as [130]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Dore, D. D., Seeger, J. D., & Chan, K. A.
Affiliations
  • Brown University (US)
  • Brigham and Women's Hospital (US)
  • Harvard University (US)
ORCID
Venue
Therapeutic Advances in Drug Safety
Publisher
SAGE Publications
Published
2012-05-15
Volume
3
Issue
4
Pages
157-164
ISSN
  • 2042-0986 (ISSN-L)
  • 2042-0994
DOI
10.1177/2042098612446473
PMC
PMC4110848
OpenAlex
W2170608522
Cited by
28
References
15
Citations by year
2026: 3 · 2025: 5 · 2024: 5 · 2022: 4 · 2021: 1 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 3 · 2015: 2 · 2014: 1 · 2013: 1
FWCI
1.80
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Therapeutic Advances in Drug Safety (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
Keywords
exenatide, thyroid cancer, pancreatic cancer, drug safety, adverse drug reactions, metformin, glibenclamide, type 2 diabetes, health insurance claims, residual confounding, outcome misclassification

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review