{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:56:16Z","timestamp":1793134576484,"version":"4.5.0"},"reference-count":49,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2025,3,1]]},"abstract":"<jats:sec id=\"ab-ooi240099-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>The increasing use of glucagon-like peptide-1 receptor agonists (GLP-1RA) demands a better understanding of their association with thyroid cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi240099-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the risk of incident thyroid cancer among adults with type 2 diabetes being treated with GLP-1RA vs other common glucose-lowering medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi240099-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This was a prespecified secondary analysis of a target trial emulation of a comparative effectiveness study using claims data for enrollees in commercial, Medicare Advantage, and Medicare fee-for-service plans across the US. Eligible participants were adults with type 2 diabetes at moderate risk for cardiovascular disease and without history of thyroid cancer who had newly filled prescriptions for GLP-1RA, sodium-glucose cotransporter 2 inhibitor (SGLT2i), dipeptidyl peptidase-4 inhibitor (DPP4i), or sulfonylurea from January 1, 2014, to December 31, 2021. Data were analyzed February 1 to October 31, 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi240099-7\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Overall and piecewise (&amp;amp;lt;1, 1-2, and \u22652 years since treatment initiation) hazard ratios (HRs) for thyroid cancer with use of GLP-1RA vs the other 3 drug classes were estimated using inverse propensity score weighted Cox proportional hazards models. Modified intention-to-treat (mITT) (primary) and as-treated (sensitivity) analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi240099-8\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 351\u202f913 patients (mean [SD] age, 65.3 [8.5] years; 173\u202f391 [49.3%] females and 178\u202f522 [50.7%] males), 41\u202f112 started treatment with GLP-1RA; 76\u202f093, with DPP4i; 43\u202f499, with SGLT2i; and 191\u202f209, with sulfonylurea therapy. The numbers of patients diagnosed with thyroid cancer were 69 (0.17%) in the GLP-1RA group, 172 (0.23%) in the DPP4i group, 72 (0.17%) in the SGLT2i group, and 381 (0.20%) in the sulfonylurea group. In the mITT analysis, GLP-1RA initiation was not significantly associated with increased overall risk for thyroid cancer compared to the other 3 diabetes drugs (HR, 1.24; 95% CI, 0.88-1.76). However, the risk for thyroid cancer was significantly higher within the first year after GLP-1RA initiation (HR, 1.85; 95% CI, 1.11-3.08) and was amplified in the overall as-treated analysis that censored patients when therapy was discontinued or another medication was added (HR, 2.07; 95% CI, 1.10-3.95).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi240099-9\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This secondary analysis of a target trial emulation of a comparative effectiveness study found that despite the low absolute risk of thyroid cancer among patients receiving GLP-1RA therapy, there was an increased risk of new thyroid cancer diagnoses within the first year of GLP-1RA initiation compared to 3 other diabetes drugs. This finding may have been due to enhanced early detection; therefore, further research is necessary to understand the underlying causes of this association.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaoto.2024.4852","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T11:32:12Z","timestamp":1737631932000},"page":"243","source":"Crossref","is-referenced-by-count":65,"title":["GLP-1RA Use and Thyroid Cancer Risk"],"prefix":"10.1001","volume":"151","author":[{"given":"Juan P.","family":"Brito","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota"},{"name":"Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeph","family":"Herrin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavya Sindhu","family":"Swarna","sequence":"additional","affiliation":[{"name":"Mayo Clinic Robert D. and Patricia E. 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