Association between incretin-based drugs and risk of cholangiocarcinoma among patients with type 2 diabetes: A large population-based matched cohort study
Year: 2024
Type: article
Study design: Observational Study
Abstract: • The incidence of cholangiocarcinoma (CCA) is increasing and has a poor prognosis. • The use of incretin -based drugs for the treatment of type 2 diabetes (T2D). • It is important to investigate the relationship between antidiabetic drugs and increased risk of developing CCA. • Neither GLP-1RAs nor DPP-4Is were associated with the increased risk of CCA. • GLP-1RAs significantly reduced the risk of CCA. To examine the association between the use of incretin-based drugs [glucagon-like peptide-1 receptor agonists (GLP-1RAs), dipeptidyl peptidase-4 inhibitors (DPP-4Is)] and the risk of cholangiocarcinoma (CCA) in the United States. This large population-based, retrospective cohort study using the TriNetX datasets included adult patients with type 2 diabetes mellitus (T2DM) who were new users of GLP-1RAs, DPP-4Is, or other second- or third-line antidiabetic drugs between 2010 and 2021. The primary outcome was the incidence of CCA. A total of 3,816,071 patients were included (mean age, 61.4 years, female, 49.3 %). A 51 % and 23 % risk reduction in CCA after 1 year of exposure to GLP-1RAs (hazard ratio 0.49; 95 % CI 0.40–0.60) and DPP4Is (0.77, 95 % CI 0.67–0.90), respectively compared to new second-or third-line users. Results were consistent at 3, 5, and 7 years of follow-up (0.66, 0.71, and 0.72 for GLP-1RAs and 0.84, 0.87, and 0.85 for DPP-4Is, respectively). Compared to new metformin users, GLP-1RA users were associated with a 42 % lower risk of developing CCA, whereas DPP-4I group was not associated with an increased risk. GLP-1RAs and DPP-4Is were not associated with a significantly increased risk of CCA. GLP-1RAs even showed a reduced risk of CCA development. They can be considered as safe and effective treatment options for patients with T2DM at risk of CCA.
Institutions: Levine Cancer Institute, Wake Forest University Health Sciences, Wake Forest University, RWTH Aachen University, Sarah Cannon Research Institute, University College London, Hospital Clínic de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona, Cleveland Clinic, King Faisal Specialist Hospital & Research Centre, Weill Cornell Medicine
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,940
OpenAlex ID: W4402654097