{"doi":"10.2337/dc25-0154","title":"Risk of Thyroid Tumors With GLP-1 Receptor Agonists: A Retrospective Cohort Study","abstract":"OBJECTIVE: To assess the association between glucagon-like peptide 1 receptor agonist (GLP-1RA) use and risk of incident thyroid tumors. RESEARCH DESIGN AND METHODS: The retrospective, active-comparator new-user cohort study used international administrative claims and electronic health record databases. Participants included patients with type 2 diabetes mellitus (T2DM) with prior metformin therapy initiating a GLP-1RA versus new users of sodium-glucose cotransporter 2 inhibitors (SGLT2is), dipeptidyl peptidase 4 inhibitors (DPP-4is), and sulfonylureas (SUs). The outcome was incident thyroid tumor and thyroid malignancy. Propensity score matching and stratification were used to adjust for confounders with an intention-to-treat and on-treatment strategy. Cox regression was used to estimate hazard ratios (HRs) pooled using a random-effects meta-analysis. Unmeasured confounding was evaluated using negative outcomes, with calibration of the HR. RESULTS: A total of 460,032 users of GLP-1RAs, 717,792 users of SGLT2is, 2,055,583 users of DPP-4is, and 1,119,868 users of SUs were included. Only U.S. cohorts passed study diagnostics. Thyroid tumor incidence ranged from 0.88 to 1.03 per 1,000 person-years in GLP-1RA cohorts. GLP-1RA exposure was not associated with an increased risk of thyroid tumors compared with SGLT2is, DPP-4is, or SUs (meta-analysis: GLP-1RA vs. SGLT2i HR range from 0.83 [95% CI 0.57-1.27] to 0.95 [0.85-1.06]; GLP-1RA vs. SU HR range from 0.95 [0.75-1.20] to 1.03 [0.87-1.23]; GLP-1RA vs. DPP-4i HR range from 0.78 [0.60-1.01] to 0.93 [0.83-1.04]). Analysis using thyroid malignancy and including a 1-year lag period produced similar conclusions. CONCLUSIONS: In patients with T2DM initiating second-line treatments, we observed no increased risk of thyroid tumors with GLP-1RA exposure.","journal":"Diabetes Care","year":2025,"id":511298,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":16,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8222,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":32100,"name":"Fan Bu","orcid":"0000-0003-3697-1477","position":1,"is_corresponding":false},{"id":1210928,"name":"Benjamin Viernes","orcid":"0000-0003-1973-9043","position":2,"is_corresponding":false},{"id":11351,"name":"Scott L. DuVall","orcid":"0000-0002-4898-3865","position":3,"is_corresponding":false},{"id":11398,"name":"Michael E. Matheny","orcid":"0000-0003-3217-4147","position":4,"is_corresponding":false},{"id":371900,"name":"Katherine Simon","orcid":"0000-0001-9232-2653","position":5,"is_corresponding":false},{"id":266935,"name":"Thomas Falconer","orcid":"0000-0001-6904-1394","position":6,"is_corresponding":false},{"id":979080,"name":"Lauren R. Richter","orcid":"0000-0001-7319-0480","position":7,"is_corresponding":false},{"id":32102,"name":"Anna Ostropolets","orcid":"0000-0002-0847-6682","position":8,"is_corresponding":false},{"id":991689,"name":"Wallis C. Y. Lau","orcid":"0000-0003-2320-0470","position":9,"is_corresponding":false},{"id":991690,"name":"Kenneth K. C. Man","orcid":"0000-0001-8645-1942","position":10,"is_corresponding":false},{"id":1010367,"name":"Shounak Chattopadhyay","orcid":null,"position":11,"is_corresponding":false},{"id":520823,"name":"Nestoras Mathioudakis","orcid":"0000-0002-0210-655X","position":12,"is_corresponding":false},{"id":32112,"name":"Evan Minty","orcid":"0000-0003-4631-9992","position":13,"is_corresponding":false},{"id":336581,"name":"Akihiko Nishimura","orcid":"0000-0002-6932-2513","position":14,"is_corresponding":false},{"id":1363629,"name":"Feng Sun","orcid":"0000-0003-4334-6805","position":15,"is_corresponding":false},{"id":991692,"name":"Can Yin","orcid":"0000-0003-1951-9649","position":16,"is_corresponding":false},{"id":258110,"name":"Sarah Seager","orcid":"0000-0002-0614-4166","position":17,"is_corresponding":false},{"id":1329425,"name":"Yi Chai","orcid":"0000-0002-2717-5981","position":18,"is_corresponding":false},{"id":1027078,"name":"Jin Zhou","orcid":"0000-0002-5534-1123","position":19,"is_corresponding":false},{"id":425636,"name":"Yuan Lu","orcid":"0009-0003-6686-5584","position":20,"is_corresponding":false},{"id":752290,"name":"Carlen Reyes","orcid":"0000-0001-8486-3265","position":21,"is_corresponding":false},{"id":32071,"name":"Andrea Pistillo","orcid":"0000-0002-4467-0220","position":22,"is_corresponding":false},{"id":32111,"name":"Talita Duarte‐Salles","orcid":"0000-0002-8274-0357","position":23,"is_corresponding":false},{"id":32052,"name":"Clair Blacketer","orcid":"0000-0003-2570-2124","position":24,"is_corresponding":false},{"id":32107,"name":"Martijn J. Schuemie","orcid":"0000-0002-0817-5361","position":25,"is_corresponding":false},{"id":32122,"name":"Patrick Ryan","orcid":"0000-0002-9727-2138","position":26,"is_corresponding":false},{"id":1077,"name":"Harlan M. Krumholz","orcid":"0000-0003-2046-127X","position":27,"is_corresponding":false},{"id":2010,"name":"George Hripcsak","orcid":"0000-0003-2664-7614","position":28,"is_corresponding":false},{"id":74880,"name":"Rohan Khera","orcid":"0000-0001-9467-6199","position":29,"is_corresponding":false},{"id":32104,"name":"Marc A. Suchard","orcid":"0000-0001-9818-479X","position":30,"is_corresponding":false},{"id":32063,"name":"Daniel R. Morales","orcid":"0000-0002-0063-8069","position":0,"is_corresponding":true}],"reference_count":36,"raw_metadata":null,"created_at":"2026-07-19T02:47:55.918021Z","pmid":"40465422","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}