GLP-1 drugs NOT associated with increased risk of thyroid cancer in large medical record database

November 16, 2023

Sometimes, when a drug is used in a huge number of people, we discover an adverse effect that wasn’t evident during clinical studies. This was true of the antiinflammatory medication Vioxx, which was discovered to increase the risk of heart attacks in men over 50 only after it was in widespread use. Researchers at Kaiser Permanente sounded the warning alarm about this class of drugs when they saw an unexpected uptick in cardiac events in their medical records.

Some rodent studies suggested that the GLP-1 drugs (such as Ozempic, Wegovy, and Mounjaro) might cause excess cases of a dangerous kind of thyroid cancer. Researchers using a national database of health care providers on the electronic medical record Epic found no evidence of excess risk of thyroid cancer. The confidence interval (the line on each bar graph) shows that those who took semaglutide appear to have a statistically significant lower rate of thyroid cancer.

Source: Bartelt, et al Epic Research Network October 10, 2023 LINK

Implications for employers:

• An FDA “black box” warning says that those with a family or personal history of medullary thyroid cancer should not be prescribed GLP-1 drugs.

• Those taking GLP-1 medications need no special screening or other tests for thyroid cancer. The decrease in BMI from these drugs will likely lead to a lower risk of obesity-associated cancers, including breast, colorectal, and endometrial cancer.

• Even with decreases in cardiovascular disease, kidney failure and possible decreases in cancer, employers should be aware that GLP-1 drugs will not lower overall health care costs.

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