{
  "abstract": "Introduction Preclinical studies suggest a potential link between glucagon-like peptide 1 receptor agonists (GLP-1RA) and thyroid cancer (TC), yet it is unclear if this risk translates to humans.Research design and methods We estimated the comparative effect of incretin-based therapies (GLP-1RA and dipeptidyl-peptidase-4 inhibitors (DPP-4i)) versus sodium-glucose cotransporter-2 inhibitors (SGLT-2i) on TC incidence among US older adults with type 2 diabetes. We defined TC as a thyroidectomy followed by ≥2 separate diagnoses codes for malignant neoplasm of thyroid gland within 90 days. We estimated adjusted 3-year cumulative risk differences of TC (aRDs) with 95% CIs using weighted Kaplan-Meier survival functions, and adjusted HRs using weighted Cox models.Results We included 73 388 new users in the GLP-1RA versus SGLT-2i cohort (mean age 72.4 years, men: 48.3%) and 106 274 in the DPP-4i versus SGLT-2i cohort (mean age 74.6 years, men: 44.9%). At 3 years and a median duration of treatment of 0.82–1.15 years, the aRD for GLP-1RA versus SGLT-2i for TC was −23 per 10 000 (95% CI: −51 to 4) and the aRD for DPP-4i versus SGLT-2i was −2 per 10 000 (95% CI: −17 to 13). Secondary and sensitivity analyses were consistent.Conclusions Our study of US Medicare beneficiaries with type 2 diabetes suggests that the initiation of incretin-based therapies may not increase the 3-year risk of TC compared with initiation of SGLT-2i. This finding offers reassurance for short-term use but does not eliminate the possibility of increased long-term or subtype-specific risks.",
  "authors": [
    {
      "affiliations": [
        "Department of Epidemiology, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA"
      ],
      "name": "Clement O Acheampong"
    },
    {
      "affiliations": [
        "Division of Endocrinology, Department of Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA"
      ],
      "name": "John B Buse"
    },
    {
      "affiliations": [
        "Division of Endocrinology, Department of Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA"
      ],
      "name": "Klara R Klein"
    },
    {
      "affiliations": [
        "Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA",
        "Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA"
      ],
      "name": "Lawrence T Kim"
    },
    {
      "affiliations": [
        "Division of Endocrinology, Department of Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA"
      ],
      "name": "Joshua Evron"
    },
    {
      "affiliations": [
        "Division of Endocrinology, Department of Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA",
        "Department of Nutrition, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA"
      ],
      "name": "Anna R Kahkoska"
    },
    {
      "affiliations": [
        "Department of Epidemiology, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA"
      ],
      "name": "Caroline A Thompson"
    },
    {
      "affiliations": [
        "Department of Epidemiology, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA"
      ],
      "name": "Tiansheng Wang"
    },
    {
      "affiliations": [
        "Department of Epidemiology, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA"
      ],
      "name": "Virginia Pate"
    },
    {
      "affiliations": [
        "NC TraCS Institute, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA"
      ],
      "name": "Peter Leese"
    },
    {
      "affiliations": [
        "Department of Epidemiology, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA"
      ],
      "name": "Til Stürmer"
    }
  ],
  "title": "Investigating the association between incretin-based therapies and thyroid cancer incidence among US Medicare beneficiaries with diabetes",
  "uid": "3a280427-84eb-5091-b324-0ea3e4aef6f3"
}