{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:16:44Z","timestamp":1792088204452,"version":"4.4.0"},"reference-count":56,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T00:00:00Z","timestamp":1713139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cVictor Babes\u201d University of Medicine and Pharmacy, Timisoara, Romania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The broadening application of glucagon-like peptide (GLP)-1 receptor agonists, specifically semaglutide (Ozempic) for the management of diabetes and obesity brings a critical need to evaluate its safety profile, considering estimates of up to 20 million prescriptions per year in the US until 2035. This systematic review aims to assess the incidence of thyroid cancer and detail the spectrum of adverse events associated with semaglutide, focusing on its implications for patient care. Through a systematic search of PubMed, Scopus, and Embase databases up to December 2023, ten randomized controlled trials (RCTs) involving 14,550 participants, with 7830 receiving semaglutide, were analyzed, with an additional number of 18 studies that were separately discussed because they reported data from the same RCTs. The review focused on thyroid cancer incidence, gastrointestinal symptoms, and other significant adverse events attributed to semaglutide. The incidence of thyroid cancer in semaglutide-treated patients was less than 1%, suggesting no significant risk. Adverse events were predominantly gastrointestinal, including nausea (2.05% to 19.95%) and diarrhea (1.4% to 13%). Nasopharyngitis and vomiting were also notable, with mean prevalences of 8.23% and 5.97%, respectively. Other adverse events included increased lipase levels (mean of 6.5%), headaches (mean prevalence of 7.92%), decreased appetite (reported consistently at 7%), influenza symptoms (mean prevalence of 5.23%), dyspepsia (mean prevalence of 5.18%), and constipation (mean prevalence of 6.91%). Serious adverse events varied from 7% to 25.2%, highlighting the need for vigilant patient monitoring. These findings underscore the gastrointestinal nature of semaglutide\u2019s adverse events, which, while prevalent, did not significantly deter from its clinical benefits in the treatment landscape. This systematic review provides a comprehensive assessment of semaglutide\u2019s safety profile, with a focus on gastrointestinal adverse events and a low incidence of thyroid cancer. Despite the prevalence of gastrointestinal symptoms, semaglutide remains an efficacious option for managing diabetes and obesity. The detailed characterization of adverse events underscores the importance of monitoring and managing these effects in clinical practice, excluding the hypothesis of carcinogenesis.<\/jats:p>","DOI":"10.3390\/ijms25084346","type":"journal-article","created":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T10:24:26Z","timestamp":1713176666000},"page":"4346","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Assessment of Thyroid Carcinogenic Risk and Safety Profile of GLP1-RA Semaglutide (Ozempic) Therapy for Diabetes Mellitus and Obesity: A Systematic Literature Review"],"prefix":"10.3390","volume":"25","author":[{"given":"Catalin","family":"Feier","sequence":"first","affiliation":[{"name":"First Discipline of Surgery, Department X-Surgery, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2 E. Murgu Sq., 300041 Timisoara, Romania"},{"name":"First Surgery Clinic, \u201cPius Brinzeu\u201d Clinical Emergency Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razvan","family":"Vonica","sequence":"additional","affiliation":[{"name":"Preclinical Department, Discipline of Physiology, Faculty of General Medicine, \u201cLucian Blaga\u201d University of Sibiu, 550169 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaviana","family":"Faur","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2 E. Murgu Sq., 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5118-2989","authenticated-orcid":false,"given":"Diana","family":"Streinu","sequence":"additional","affiliation":[{"name":"Department of Doctoral Studies, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2 E. Murgu Sq., 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0497-0405","authenticated-orcid":false,"given":"Calin","family":"Muntean","sequence":"additional","affiliation":[{"name":"Medical Informatics and Biostatistics, Department III-Functional Sciences, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2 E. Murgu Sq., 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e5516","DOI":"10.1097\/GOX.0000000000005516","article-title":"Injectable Weight Loss Medications in Plastic Surgery: What We Know, Perioperative Considerations, and Recommendations for the Future","volume":"12","author":"Wiegmann","year":"2024","journal-title":"Plast. Reconstr. Surg. Glob. Open"},{"key":"ref_2","unstructured":"Constantino, A.K. (2023, October 14). Ozempic, Wegovy Drug Prescriptions Hit 9 Million, Surge 300% in under Three Years. CNBC. Available online: https:\/\/www.cnbc.com\/2023\/09\/27\/ozempic-wegovy-drug-prescriptions-hit-9-million.html."},{"key":"ref_3","unstructured":"Lucas, A. (2023, October 14). Big Food vs. Big pharma: Companies Bet on Snacking Just as Weight Loss Drugs Boom. CNBC. Available online: https:\/\/www.cnbc.com\/2023\/10\/01\/kellanova-bets-on-snacking-as-ozempic-wegovy-take-off.html."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1007\/s11154-021-09699-1","article-title":"Semaglutide, a glucagon like peptide-1 receptor agonist with cardiovascular benefits for management of type 2 diabetes","volume":"23","author":"Mahapatra","year":"2022","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"9946924","DOI":"10.1155\/2023\/9946924","article-title":"Glucagon-Like Peptide-1 Receptor Agonists for Chronic Weight Management","volume":"2023","author":"Wojtara","year":"2023","journal-title":"Adv. Med."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Lombrea, A., Romanescu, M., Jianu, N., Andor, M., Suciu, M., Man, D.E., Danciu, C., Dehelean, C.A., and Buda, V. (2023). Sex-Related Differences in the Pharmacological Response in SARS-CoV-2 Infection, Dyslipidemia, and Diabetes Mellitus: A Narrative Review. Pharmaceuticals, 16.","DOI":"10.3390\/ph16060853"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1111\/dom.13120","article-title":"Semaglutide improves postprandial glucose and lipid metabolism, and delays first-hour gastric emptying in subjects with obesity","volume":"20","author":"Hjerpsted","year":"2018","journal-title":"Diabetes Obes. Metab."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1007\/s11095-022-03302-1","article-title":"Therapeutic Potential of Semaglutide, a Newer GLP-1 Receptor Agonist, in Abating Obesity, Non-Alcoholic Steatohepatitis and Neurodegenerative diseases: A Narrative Review","volume":"39","author":"Mahapatra","year":"2022","journal-title":"Pharm. Res."},{"key":"ref_9","unstructured":"(2024, February 15). Clinical Review Report: Semaglutide (Ozempic): (Novo Nordisk Canada Inc.): Indication: For the Treatment of Adult Patients with Type 2 Diabetes Mellitus to Improve Glycemic Control, in Combination with Metformin (Second-Line Treatment), and in Combination with Metformin and Sulfonylurea (Third-Line Treatment) [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK544016\/."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"100387","DOI":"10.1016\/j.xcrm.2021.100387","article-title":"Levels of circulating semaglutide determine reductions in HbA1c and body weight in people with type 2 diabetes","volume":"2","author":"Overgaard","year":"2021","journal-title":"Cell Rep. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"996179","DOI":"10.3389\/fpubh.2022.996179","article-title":"Gastrointestinal adverse events associated with semaglutide: A pharmacovigilance study based on FDA adverse event reporting system","volume":"10","author":"Shu","year":"2022","journal-title":"Front. Public Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"483","DOI":"10.31925\/farmacia.2020.3.14","article-title":"The presence of peripheral inflammatory markers in patients with major depressive disorder, the associated symptoms profiles and the antidepressant efficacy of celecoxib","volume":"68","author":"Enatescu","year":"2020","journal-title":"Farmacia"},{"key":"ref_13","first-page":"1588","article-title":"Combination therapy with once-weekly glucagon like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors in type 2 diabetes: A case series","volume":"17","author":"Lajthia","year":"2019","journal-title":"Pharm. Pract."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Jianu, C., Rusu, L.C., Muntean, I., Cocan, I., Lukinich-Gruia, A.T., Gole\u021b, I., Horhat, D., Mioc, M., Mioc, A., and \u0218oica, C. (2022). In Vitro and In Silico Evaluation of the Antimicrobial and Antioxidant Potential of Thymus pulegioides Essential Oil. Antioxidants, 11.","DOI":"10.3390\/antiox11122472"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"925377","DOI":"10.3389\/fphar.2022.925377","article-title":"GLP-1 receptor agonist-associated tumor adverse events: A real-world study from 2004 to 2021 based on FAERS","volume":"13","author":"Yang","year":"2022","journal-title":"Front. Pharmacol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"645563","DOI":"10.3389\/fendo.2021.645563","article-title":"Safety of Semaglutide","volume":"12","author":"Smits","year":"2021","journal-title":"Front. Endocrinol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1210\/en.2009-1272","article-title":"Glucagon-like Peptide-1 receptor agonists activate rodent thyroid C-cells causing calcitonin release and C-cell proliferation","volume":"151","author":"Madsen","year":"2010","journal-title":"Endocrinology."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"249","DOI":"10.2337\/dci22-0052","article-title":"Putting GLP-1 RAs and Thyroid Cancer in Context: Additional Evidence and Remaining Doubts","volume":"46","author":"Thompson","year":"2023","journal-title":"Diabetes Care"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"A893","DOI":"10.1210\/jendso\/bvab048.1823","article-title":"Medullary Carcinoma of Thyroid Due to GLP-1 Receptor Agonist","volume":"5","author":"Vemula","year":"2021","journal-title":"J. Endocr. Soc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"4449","DOI":"10.2147\/DDDT.S365416","article-title":"Clinical Insight on Semaglutide for Chronic Weight Management in Adults: Patient Selection and Special Considerations","volume":"16","author":"Chao","year":"2022","journal-title":"Drug Des. Devel. Ther."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s13643-021-01626-4","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"10","author":"Page","year":"2021","journal-title":"Syst. Rev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","article-title":"Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses","volume":"25","author":"Stang","year":"2010","journal-title":"Eur. J. Epidemiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/S2213-8587(17)30092-X","article-title":"Efficacy and safety of once-weekly semaglutide versus once-daily sitagliptin as an add-on to metformin, thiazolidinediones, or both, in patients with type 2 diabetes (SUSTAIN 2): A 56-week, double-blind, phase 3a, randomised trial","volume":"5","author":"Masmiquel","year":"2017","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e001649","DOI":"10.1136\/bmjdrc-2020-001649","article-title":"Long-term efficacy and safety of oral semaglutide and the effect of switching from sitagliptin to oral semaglutide in patients with type 2 diabetes: A 52-week, randomized, open-label extension of the PIONEER 7 trial","volume":"8","author":"Buse","year":"2020","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1056\/NEJMoa1901118","article-title":"Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes","volume":"381","author":"Husain","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1056\/NEJMoa1607141","article-title":"Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes","volume":"375","author":"Marso","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S0140-6736(19)31271-1","article-title":"Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): A randomised, double-blind, phase 3a trial","volume":"394","author":"Pratley","year":"2019","journal-title":"Lancet"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.1001\/jama.2019.2942","article-title":"Effect of Additional Oral Semaglutide vs Sitagliptin on Glycated Hemoglobin in Adults with Type 2 Diabetes Uncontrolled with Metformin Alone or with Sulfonylurea: The PIONEER 3 Randomized Clinical Trial","volume":"321","author":"Rosenstock","year":"2019","journal-title":"JAMA"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/S2213-8587(17)30013-X","article-title":"Efficacy and safety of once-weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1): A double-blind, randomised, placebo-controlled, parallel-group, multinational, multicentre phase 3a trial","volume":"5","author":"Sorli","year":"2017","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1001\/jama.2021.1831","article-title":"Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults with Overweight or Obesity: The STEP 3 Randomized Clinical Trial","volume":"325","author":"Wadden","year":"2021","journal-title":"JAMA"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1111\/dom.14725","article-title":"Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension","volume":"24","author":"Wilding","year":"2022","journal-title":"Diabetes Obes. Metab."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/S2213-8587(20)30075-9","article-title":"PIONEER 9 investigators. Dose-response, efficacy, and safety of oral semaglutide monotherapy in Japanese patients with type 2 diabetes (PIONEER 9): A 52-week, phase 2\/3a, randomised, controlled trial","volume":"8","author":"Yamada","year":"2020","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1724","DOI":"10.2337\/dc19-0749","article-title":"PIONEER 1: Randomized Clinical Trial of the Efficacy and Safety of Oral Semaglutide Monotherapy in Comparison with Placebo in Patients with Type 2 Diabetes","volume":"42","author":"Aroda","year":"2019","journal-title":"Diabetes Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/S2213-8587(19)30192-5","article-title":"Efficacy and safety of oral semaglutide in patients with type 2 diabetes and moderate renal impairment (PIONEER 5): A placebo-controlled, randomised, phase 3a trial","volume":"7","author":"Mosenzon","year":"2019","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2262","DOI":"10.2337\/dc19-0898","article-title":"Efficacy, Safety, and Tolerability of Oral Semaglutide Versus Placebo Added to Insulin with or without Metformin in Patients with Type 2 Diabetes: The PIONEER 8 Trial","volume":"42","author":"Zinman","year":"2019","journal-title":"Diabetes Care"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/S0140-6736(21)00213-0","article-title":"Semaglutide 2\u00b74 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): A randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial","volume":"397","author":"Davies","year":"2021","journal-title":"Lancet"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/S2468-1253(23)00068-7","article-title":"Semaglutide 2\u00b74 mg once weekly in patients with non-alcoholic steatohepatitis-related cirrhosis: A randomised, placebo-controlled phase 2 trial","volume":"8","author":"Loomba","year":"2023","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1001\/jama.2021.3224","article-title":"Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults with Overweight or Obesity: The STEP 4 Randomized Clinical Trial","volume":"325","author":"Rubino","year":"2021","journal-title":"JAMA"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1038\/s41591-022-02026-4","article-title":"Two-year effects of semaglutide in adults with overweight or obesity: The STEP 5 trial","volume":"28","author":"Garvey","year":"2022","journal-title":"Nat. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/S2213-8587(22)00008-0","article-title":"Semaglutide once a week in adults with overweight or obesity, with or without type 2 diabetes in an east Asian population (STEP 6): A randomised, double-blind, double-dummy, placebo-controlled, phase 3a trial","volume":"10","author":"Kadowaki","year":"2022","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2245","DOI":"10.1056\/NEJMoa2208601","article-title":"Once-Weekly Semaglutide in Adolescents with Obesity","volume":"387","author":"Weghuber","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1056\/NEJMoa2028395","article-title":"A Placebo-Controlled Trial of Subcutaneous Semaglutide in Nonalcoholic Steatohepatitis","volume":"384","author":"Newsome","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/S0140-6736(18)31773-2","article-title":"Efficacy and safety of semaglutide compared with liraglutide and placebo for weight loss in patients with obesity: A randomised, double-blind, placebo and active controlled, dose-ranging, phase 2 trial","volume":"392","author":"Birkenfeld","year":"2018","journal-title":"Lancet."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/S2213-8587(19)30311-0","article-title":"Efficacy and safety of once-weekly semaglutide versus daily canagliflozin as add-on to metformin in patients with type 2 diabetes (SUSTAIN 8): A double-blind, phase 3b, randomised controlled trial","volume":"7","author":"Lingvay","year":"2019","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1056\/NEJMoa2107519","article-title":"Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes","volume":"385","author":"Davies","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.diabet.2019.101117","article-title":"Efficacy and safety of once-weekly semaglutide 1.0mg vs once-daily liraglutide 1.2mg as add-on to 1-3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10)","volume":"46","author":"Capehorn","year":"2020","journal-title":"Diabetes Metab."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1788","DOI":"10.1111\/dom.14765","article-title":"Effect of once-weekly semaglutide versus thrice-daily insulin aspart, both as add-on to metformin and optimized insulin glargine treatment in participants with type 2 diabetes (SUSTAIN 11): A randomized, open-label, multinational, phase 3b trial","volume":"24","author":"Kellerer","year":"2022","journal-title":"Diabetes Obes. Metab."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1111\/dom.14232","article-title":"Efficacy and safety of once-weekly semaglutide versus once-daily sitagliptin as add-on to metformin in patients with type 2 diabetes in SUSTAIN China: A 30-week, double-blind, phase 3a, randomized trial","volume":"23","author":"Ji","year":"2021","journal-title":"Diabetes Obes. Metab."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1111\/dom.13218","article-title":"Safety and efficacy of once-weekly semaglutide vs additional oral antidiabetic drugs in Japanese people with inadequately controlled type 2 diabetes: A randomized trial","volume":"20","author":"Kaku","year":"2018","journal-title":"Diabetes Obes. Metab."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"102834","DOI":"10.1016\/j.dsx.2023.102834","article-title":"Semaglutide and cancer: A systematic review and meta-analysis","volume":"17","author":"Nagendra","year":"2023","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1111\/dom.15382","article-title":"Glucagon-like peptide-1 receptor agonists and risk of thyroid cancer: A systematic review and meta-analysis of randomized controlled trials","volume":"26","author":"Silverii","year":"2024","journal-title":"Diabetes Obes. Metab."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"384","DOI":"10.2337\/dc22-1148","article-title":"GLP-1 Receptor Agonists and the Risk of Thyroid Cancer","volume":"46","author":"Bezin","year":"2023","journal-title":"Diabetes Care"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1111\/obr.12321","article-title":"Adiposity and risk of thyroid cancer: A systematic review and meta-analysis","volume":"16","author":"Schmid","year":"2015","journal-title":"Obes. Rev."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"927859","DOI":"10.3389\/fendo.2022.927859","article-title":"Use of GLP-1 Receptor Agonists and Occurrence of Thyroid Disorders: A Meta-Analysis of Randomized Controlled Trials","volume":"13","author":"Hu","year":"2022","journal-title":"Front. Endocrinol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1210\/en.2010-0115","article-title":"Minireview: Update on incretin biology: Focus on glucagon-like peptide-1","volume":"151","author":"Brubaker","year":"2010","journal-title":"Endocrinology"},{"key":"ref_56","unstructured":"European Medicines Agency (2024, February 15). Meeting Highlights from the Pharmacovigilance Risk Assessment Committee (PRAC) 23\u201326 October 2023. EMA, Available online: https:\/\/www.ema.europa.eu\/en\/news\/meeting-highlights-pharmacovigilance-risk-assessment-committee-prac-23-26-october-2023."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/25\/8\/4346\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:27:58Z","timestamp":1760106478000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/25\/8\/4346"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,15]]},"references-count":56,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["ijms25084346"],"URL":"https:\/\/doi.org\/10.3390\/ijms25084346","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,15]]}}}