一般的な糖尿病治療薬は甲状腺がんリスクを増加させないことが示唆される(Popular diabetes drugs do not increase thyroid cancer risk, study suggests)

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2024-04-10 カロリンスカ研究所(KI)

GLP-1アナログとして知られる薬物は、糖尿病と肥満の治療に広く使われていますが、甲状腺がんのリスクを増加させる可能性があるとの懸念がありました。しかし、カロリンスカ研究所の研究者による包括的なスカンジナビアの研究で、約14万5000人の患者を対象にしたレジスターのデータ分析から、GLP-1アナログ治療は甲状腺がんのリスクを増加させないことが示されました。

<関連情報>

グルカゴン様ペプチド1受容体作動薬の使用と甲状腺がんリスク: スカンジナビアのコホート研究 Glucagon-like peptide 1 receptor agonist use and risk of thyroid cancer: Scandinavian cohort study

Björn Pasternak, principal researcher; Viktor Wintzell, statistician; Anders Hviid, professor; Björn Eliasson, associate professor; Soffia Gudbjörnsdottir, professor; Christian Jonasson, senior researcher; Kristian Hveem, professor;Henrik Svanström, senior researcher;Mads Melbye, professor;Peter Ueda, assistant professor
The BMJ  Published:10 April 2024
DOI:https://doi.org/10.1136/bmj-2023-078225

一般的な糖尿病治療薬は甲状腺がんリスクを増加させないことが示唆される(Popular diabetes drugs do not increase thyroid cancer risk, study suggests)

Abstract

Objective To investigate whether use of glucagon-like peptide 1 (GLP1) receptor agonists is associated with increased risk of thyroid cancer.

Design Scandinavian cohort study.

Setting Denmark, Norway, and Sweden, 2007-21.

Participants Patients who started GLP1 receptor agonist treatment were compared with patients who started dipeptidyl peptidase 4 (DPP4) inhibitor treatment, and in an additional analysis, patients who started sodium-glucose cotransporter 2 (SGLT2) inhibitor treatment.

Main outcome measures Thyroid cancer identified from nationwide cancer registers. An active-comparator new user study design was used to minimise risks of confounding and time related biases from using real world studies of drug effects. Cox regression was used to estimate hazard ratios, controlling for potential confounders with propensity score weighting.

Results The mean follow-up time was 3.9 years (standard deviation 3.5 years) in the GLP1 receptor agonist group and 5.4 years (standard deviation 3.5 years) in the DPP4 inhibitor group. 76 of 145 410 patients (incidence rate 1.33 events per 10 000 person years) treated with GLP1 receptor agonists and 184 of 291 667 patients (incidence rate 1.46 events per 10 000 person years) treated with DPP4 inhibitors developed thyroid cancer. GLP1 receptor agonist use was not associated with increased risk of thyroid cancer (hazard ratio 0.93, 95% confidence interval 0.66 to 1.31; rate difference -0.13, 95% confidence interval -0.61 to 0.36 events per 10 000 person years). The hazard ratio for medullary thyroid cancer was 1.19 (0.37 to 3.86). In the additional analysis comparing the GLP1 receptor agonist group with the SGLT2 inhibitor group, the hazard ratio for thyroid cancer was 1.16 (0.65 to 2.05).

Conclusions In this large cohort study using nationwide data from three countries, GLP1 receptor agonist use was not associated with a substantially increased risk of thyroid cancer over a mean follow-up of 3.9 years. In the main analysis comparing GLP1 receptor agonists with DPP4 inhibitors, the upper limit of the confidence interval was consistent with no more than a 31% increase in relative risk.

有機化学・薬学
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