Risk for CRC Reduced With GLP-1RAs for Drug-Naive Patients With T2D

MONDAY, Dec. 11, 2023 (HealthDay News) -- For drug-naive patients with type 2 diabetes (T2D), glucagon-like peptide 1 receptor agonists (GLP-1RAs) are associated with a reduced risk for colorectal cancer (CRC) compared with other antidiabetics, including insulin and metformin, according to a research letter published online Dec. 7 in JAMA Oncology.

Lindsey Wang, from the Case Western Reserve University School of Medicine in Cleveland, and colleagues conducted a nationwide, retrospective cohort study among drug-naive patients with T2D receiving GLP-1RAs or non-GLP-1RA antidiabetics to compare the risk for CRC. The study population included 1,221,218 patients with T2D and no prior antidiabetic medication use who were prescribed antidiabetic medications from 2005 to 2019. GLP-1RAs were compared to insulin, metformin, alpha-glucosidase inhibitors, dipeptidyl-peptidase4 (DPP-4) inhibitors, sodium-glucose cotransporter-2 (SGLT2) inhibitors, sulfonylureas, and thiazolidinediones. The outcome was first diagnosis of CRC within 15 years of first prescription with a GLP-1RA or non-GLP-1RA antidiabetic.

The researchers found that GLP-1RAs were associated with a reduced risk for CRC compared with insulin and metformin (hazard ratios, 0.56 and 0.75, respectively), SGLT2 inhibitors, sulfonylureas, and thiazolidinediones, as well as a nonsignificantly lower risk compared with alpha-glucosidase and DPP-4 inhibitors. The findings were consistent for men and women. In patients with obesity/overweight, GLP-1RAs were associated with a lower risk for CRC compared with insulin and metformin (hazard ratios, 0.50 and 0.58, respectively) or other antidiabetics.

"GLP-1RAs were associated with reduced CRC risk in drug-naive patients with T2D with and without obesity/overweight, with more profound effects in patients with obesity/overweight," the authors write.

Abstract/Full Text