The investigators used the TriNetX database to identify patients with T2DM who were prescribed an antidiabetic medication between 2005 and 2019 and had no history of urologic cancer. This resulted in a final cohort of 1,276,762 patients. There was a comparable distribution across the following medication types: GLP1R agonist, metformin, sulfonylurea (SU), thiazolidinedione (TZD), SGLT2 inhibitor, DDP4 inhibitor, and insulin. The only cohort subsequently eliminated due to the small sample size was patients treated with ɑ-glucosidase inhibitor (AGI). GLP1R agonist treatment was associated with higher bladder cancer (BC) incidence compared to SGLT2 inhibitors (HR, 1.47; 95% CI, 1.06 – 2.04; p = 0.02). GLP1R agonist treatment was also associated with a higher risk of kidney cancer (KC) than metformin treatment (HR, 1.45; 95% CI, 1.13 – 1.86; p = 0.003) and a higher risk of prostate cancer (PC) than insulin treatment (HR, 1.32; 95% CI, 1.07 – 1.63; p = 0.010).
A key strength of this study is the large sample size. Limitations include its inherent observational nature and limited data available on other clinical parameters and risk factors that may be relevant to the development of the investigated cancers. This study adds to the data examining the risk of bladder cancer associated with GLP1R agonists.
Written by: Bishoy M. Faltas, MD, Director of Bladder Cancer Research, Englander Institute for Precision Medicine, Weill Cornell Medicine
References
- Bukavina L, Helstrom E, Wallis CJD, et al. Association Between GLP1R Agonists and Prostate, Kidney, and Bladder Cancers. Eur Urol Oncol. Published online May 2, 2024. doi:10.1016/j.euo.2024.04.006