Glucagon-like peptide-1 receptor agonists (GLP-1RA) – a class of drugs prescribed to treat type 2 diabetes and obesity – have seen a surge of popularity in recent years.
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They said this is an important finding as type 2 diabetes is associated with a higher risk of most cancers.
The study’s lead author told Medical News Today that this data should help doctors and patients alike to make informed choices when treating type 2 diabetes – and the implications for people with obesity are significant as well.
Dr. Rachel Dankner of the Gertner Institute for Epidemiology and Health Policy Research at the Sheba Medical Center in Israel led the study.
She told Medical News Today that her earlier research showed a strong correlation between type 2 diabetes and most cancers, particularly liver cancer and pancreatic cancer.
Because of this, it was especially important to know if drugs commonly used to treat type 2 diabetes – like those in the GLP-1RA class – might help explain the association.
“We were especially interested to reveal if there is any association between the incretines like DPP-4 inhibitors and GLP-1RAs and pancreatic cancer, since early on, when these drugs were just released, there were concerns that they may be associated with pancreatitis and with pancreatic cancer,” Dankner explained.
Because the GLP-1RA class is relatively new, researchers don’t have decades of data to draw from. However, Dankner and her colleagues did analyze a large population of nearly half a million adults with type 2 diabetes, with a follow-up period of 7 years.
“When you embark on a study with a new question, you try to stay objective and not to expect positive or negative findings,” she said. “Nevertheless, we were happy to find no association between these very important medications and a very aggressive cancer that is causing a lot of suffering and a very high mortality rate. We were also relieved to find out that this association persisted when we accounted for past history of pancreatitis, which is an important risk factor for pancreatic cancer.”
This finding was particularly important, Dankner said, because physicians often avoid prescribing GLP-1RAs to people with a history of pancreatitis.
Various types of GLP-1RA have been approved by the U.S. Food and Drug Administration, including exenatide, liraglutide, albiglutide, dulaglutide, lixisenatide, semaglutide, and tirzepatide.
These names might be unfamiliar, but the brand names they’re sold under – such as Ozempic, Rybelsus, Wegovy, and Mounjaro – are quickly becoming household names.
Dr. Mir Ali, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California, outlined some of the ways in which the drugs work.
“The observation was made that patients taking these medications would lose weight,” Ali, who was not involved in the study, told Medical News Today. “Patients feel less hungry because these drugs slow the emptying of the stomach, so they feel full for longer.”
Ali said that while these drugs have been on the market for some time, they’ve really gained in popularity in the past few years – a factor that’s led to shortages as manufacturers struggle to keep up with demand.
For those who are prescribed a GLP-1 receptor agonist, it’s important to note that they’ll be most effective when combined with lifestyle changes.
“We as physicians really require the patient to change to a healthier lifestyle and those are the patients who are most successful,” Ali said. “So medication helps, but if the patient fails to make the right food choices, they may not see the expected results. Or if they go back to the old ways after stopping the medication, they may regain weight. So these medications are more like chronic treatment, like we treat high blood pressure or diabetes.”
Ali points out that while most side effects of these medications are relatively mild, it’s still important that anyone considering these drugs consult with a physician.
“Endocrine conditions and relatively rare thyroid conditions have a contraindication to take these medications, so patients definitely need to start with their primary doctors if they fall into any of these categories,” he said.
Dankner says that more data will help researchers better understand the factors at play beyond the initial 7-year follow-up period.
However, she noted that the data published this week should help guide physicians when prescribing medications from the GLP-1RA class.
“These medications are proven excellent for weight reduction and weight control, and since obesity is such a huge problem, especially in diabetic patients, these medications not only treat hyperglycemia, but also obesity, which makes them a great choice when treating a diabetic patient with obesity,” she explained.