{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T04:02:39Z","timestamp":1784520159929,"version":"3.55.0"},"reference-count":55,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Preclinical studies have suggested that glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101RAs) may induce thyroid gland hyperplasia, raising concerns about potential thyroid\u2010related risks. Given their increasing use and the limited evidence on thyroid safety, this study assessed the association between GLP\u20101RA use and the incidence of hypothyroidism using real\u2010world data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an active\u2010comparator, new\u2010user cohort study using the Real\u2010World Evidence Research Network (SRWEN) (2016\u20132023). Adults (\u2265\u200918\u2009years) initiating GLP\u20101RAs or dipeptidyl peptidase\u20104 inhibitors (DPP\u20104is) were followed from first prescription until hypothyroidism, treatment discontinuation, switching, death, or study end. Hypothyroidism was identified through ICD\u201010 codes or levothyroxine prescriptions. Inverse probability of treatment weighting was applied to adjust for confounding, and weighted Cox proportional hazards models were used to estimate hazard ratios (HRs). RStudio 4.4.0 was used for analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 47\u2009017 patients were included (6800 GLP\u20101RA users; 40\u2009217 DPP\u20104i users). GLP\u20101RA users were younger (mean age 50 vs. 58\u2009years) and more often female. The incidence rate of hypothyroidism was 128 per 10\u2009000 person\u2010years in GLP\u20101RA users compared to 150 per 10\u2009000 person\u2010years in DPP\u20104i users. GLP\u20101RA use was not associated with a statistically significant risk of hypothyroidism (adjusted HR 1.04, 95% CI 0.69\u20131.57). Sensitivity analyses extending follow\u2010up by 30 and 60\u2009days yielded consistent findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this real\u2010world analysis, GLP\u20101RA use was not associated with an increased incidence of hypothyroidism compared to DPP\u20104is. Findings were consistent across sensitivity and subgroup analyses. Although findings do not suggest a short\u2010term risk, longer\u2010term studies are warranted to further evaluate thyroid safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70315","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T23:51:08Z","timestamp":1767657068000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Risk of Hypothyroidism With the Use of\n                    <scp>GLP<\/scp>\n                    \u20101 Receptor Agonists in Saudi Arabia"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5284-1805","authenticated-orcid":false,"given":"Almaha","family":"Alfakhri","sequence":"first","affiliation":[{"name":"Saudi Food and Drug Authority  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ohoud","family":"Almadani","sequence":"additional","affiliation":[{"name":"Saudi Food and Drug Authority  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raseel","family":"Alroba","sequence":"additional","affiliation":[{"name":"Saudi Food and Drug Authority  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9422-7390","authenticated-orcid":false,"given":"Adel","family":"Alrwisan","sequence":"additional","affiliation":[{"name":"Saudi Food and Drug Authority  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Alshaya","sequence":"additional","affiliation":[{"name":"King Abdulaziz Medical City, Ministry of National Guard\u2010Health Affairs  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2816-6526","authenticated-orcid":false,"given":"Yasser","family":"Albogami","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy College of Pharmacy, King Saud University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m4573"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n1091"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc24\u2010S009"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2200436"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.055459"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102022\u2010061807"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2024.111770"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci24\u20100003"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25084346"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1530\/EC\u201023\u20100257"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15382"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.925377"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.13259"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc22\u20101148"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S305496"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13300\u2010021\u201001021\u20101"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15292"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102023\u2010078225"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.24018\/ejmed.2023.5.3.1743"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1159\/000501895"},{"issue":"2","key":"e_1_2_10_22_1","first-page":"174","article-title":"Serum Levels of Glucagon\u2010Like Peptide (GLP)\u20101 and GLP\u20102 in Patients With Hashimoto's Thyroiditis","volume":"20","author":"Jin Y.","year":"2015","journal-title":"Journal of Research in Medical Sciences"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/biom14060687"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.927859"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5025"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010017\u201007921\u20102"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.29011\/2574\u20107754.100458"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3004"},{"key":"e_1_2_10_29_1","unstructured":"European Medicines Agency Saxenda (Liraglutide) [Summary Of Product Characteristics](2025) https:\/\/www.ema.europa.eu\/en\/documents\/product\u2010information\/saxenda\u2010epar\u2010product\u2010information_en.pdf."},{"key":"e_1_2_10_30_1","unstructured":"European Medicines Agency Victoza (Liraglutide) [Summary Of Product Characteristics](2025) https:\/\/www.ema.europa.eu\/en\/documents\/product\u2010information\/victoza\u2010epar\u2010product\u2010information_en.pdf."},{"key":"e_1_2_10_31_1","unstructured":"European Medicines Agency Ozempic (Semaglutide) [Summary of Product Characteristics](2025) https:\/\/www.ema.europa.eu\/en\/documents\/product\u2010information\/ozempic\u2010epar\u2010product\u2010information_en.pdf."},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.13024"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1901214"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/21925682251346114"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1080\/02813432.2023.2213748"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5330"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab158"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwab041"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgae722"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14901"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/1786559"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.02349"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgac006"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.20697"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2014.11.009"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2023.29.1.90"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325\u2010020\u201001615\u20104"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1093\/crocol\/otad045"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41392\u2010024\u201001931\u2010z"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010024\u201003412\u2010w"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41569\u2010023\u201000849\u20103"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2024.0387"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1080\/14740338.2025.2499670"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.10.062"},{"key":"e_1_2_10_56_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.16376"}],"container-title":["Pharmacoepidemiology and Drug Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.70315","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pds.70315","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.70315","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T03:23:46Z","timestamp":1784517826000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pds.70315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":55,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/pds.70315"],"URL":"https:\/\/doi.org\/10.1002\/pds.70315","archive":["Portico"],"relation":{},"ISSN":["1053-8569","1099-1557"],"issn-type":[{"value":"1053-8569","type":"print"},{"value":"1099-1557","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-10-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70315"}}