Nutritionist calculating body mass index of woman for obesity treatment in a clinic room. Current research shows the gut microbiome may also influence risk for obesity.
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In a comprehensive study spanning three Scandinavian countries, researchers from the Karolinska Institute in Sweden have found no significant link between the use of GLP-1 analogues, a popular class of diabetes drugs, and an increased risk of thyroid cancer.

Published in The BMJ, the study aims to put to rest concerns over the safety of the widely used medications.

First approved by the FDA in 2019, oral GLP-1 receptor agonists, also known as GLP-1 analogues, have revolutionized treatment of type 2 diabetes and obesity. By reducing blood sugar levels and curbing appetite, they offer a dual approach to managing the conditions and are used by millions of people worldwide. Despite the success, their safety profile has been under scrutiny due to previous studies and adverse event reports suggesting a potential link to thyroid tumors.

The research team, led by Björn Pasternak, PhD, of the department of medicine at the Karolinska Institute, embarked on an extensive study to investigate these concerns.

“Many people take these medicines, so it is important to study potential risks associated with them,” Pasternak explained in a press statement.

Using national register data from Denmark, Norway, and Sweden, the study compared approximately 145,000 patients treated with GLP-1 analogues, primarily liraglutide or semaglutide, against 290,000 patients who received DPP4 inhibitors, another class of diabetes medication. The comparison extended over an average follow-up period of nearly four years.

The findings were reassuring. According to the researchers, the use of GLP-1 treatment was not associated with an elevated risk of thyroid cancer when compared to the use of DPP4 inhibitors or a third group of diabetes medications, SGLT2 inhibitors. This conclusion adds a significant layer of confidence in the safety of GLP-1 analogues for a broad patient demographic.

“We cannot rule out that the risk of certain subtypes of thyroid cancer is increased in smaller patient groups that we could not study here, for example in people with a high congenital risk of medullary thyroid cancer who are advised against using these drugs,” explained Peter Ueda, assistant professor at the Department of Medicine at Karolinska Institutet.

Supported by the Swedish Cancer Society, the Swedish Research Council, and Karolinska Institutet itself, the study also maintains transparency regarding potential conflicts of interest among its authors, ensuring the credibility of its findings.

The researchers believe that the study result is a step forward in validating the safety profile of GLP-1 analogues, offering peace of mind to patients and healthcare providers alike as they continue to be used in treating diabetes and obesity.

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