Diabetes Drug Cuts Blood Cancer Risk

TOPLINE:

Glucagon-like peptide 1 receptor agonists (GLP-1RA) are linked to a 54% lower risk for developing hematologic cancers than insulin in patients with type 2 diabetes (T2D). The medication shows particular effectiveness in reducing risk for myelodysplastic syndromes and myeloproliferative neoplasms vs metformin.

METHODOLOGY:

• Researchers conducted a retrospective cohort study using TriNetX, an electronic health record repository covering approximately one quarter of the US population, between April 30, 2005, and October 31, 2023.
• Analysis included 1,601,334 patients with T2D (mean age 62.5 years; 46.9% women), of whom 51,617 received exclusively GLP-1RA, 611,115 received metformin, and 938,602 received insulin.
• Participants were propensity matched 1:1 using nearest neighbor greedy matching algorithm for demographics, weight status, body mass index, diabetic complications, hemoglobin A1c, genetic susceptibility, and other factors.
• Primary outcome measure was first diagnosis of hematologic cancer within 15 years of antidiabetic agent prescription, with hazard ratios and cumulative incidences estimated using Cox proportional hazard and Kaplan-Meier analyses.

TAKEAWAY:

• GLP-1RA use was associated with significantly lower risk for myeloid leukemia (hazard ratio [HR], 0.39; 95% CI, 0.25-0.60; P < .001), lymphoid leukemia (HR, 0.45; 95% CI, 0.30-0.68; P < .001), and non-Hodgkin lymphoma (HR, 0.42; 95% CI, 0.30-0.58; P < .001) than insulin.
• GLP-1RA demonstrated reduced risk for myelodysplastic syndromes (HR, 0.19; 95% CI, 0.11-0.35; P < .001) and myeloproliferative neoplasms (HR, 0.50; 95% CI, 0.41-0.61; P < .001) compared with insulin therapy.
• GLP-1RA showed lower risk for myelodysplastic syndromes (HR, 0.61; 95% CI, 0.42-0.89; P = .01) and myeloproliferative neoplasms (HR, 0.67; 95% CI, 0.52-0.87; P = .002) than metformin.
• Across all hematologic cancers, GLP-1RA use was associated with 54% lower risk than insulin therapy, suggesting potential protective effects against blood cancer development.

IN PRACTICE:

“The findings of this cohort study suggest that GLP-1RAs are associated with reduced risk of developing several hematologic cancers, particularly MDS and MPN, in patients with T2D. This reduction in risk may be mediated by weight loss, the immunomodulatory properties of GLP-1RAs, or both,” wrote the authors of the study.

SOURCE:

The study was led by Omer Ashruf, Cleveland Clinic Lerner College of Medicine in Cleveland. It was published online on March 6 in JAMA Network Open.

LIMITATIONS:

According to the authors, study limitations included reliance on encounter codes, residual confounding by indication, limited adjustment for multiple testing and sensitivity analysis, lack of age stratification, and absence of dose-response relationships. The researchers also noted that the study’s design did not allow for comprehensive exploration of the biological pathways through which GLP-1RAs may prevent cancer development.

DISCLOSURES:

The study received support from the Clinical and Translational Science Collaborative of Cleveland, funded by the National Institutes of Health, National Center for Advancing Translational Sciences, and Clinical and Translational Science Award (grant UL1TR002548). Faiz Anwer, MD, reported receiving personal fees from Celgene, BMS, and Carobou outside the submitted work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.