背景:胰高血糖素样肽-1受体激动剂(GLP-1RA)通常用于降低葡萄糖和减轻体重。然而,它们与胃肠道癌的关系仍不确定.这项荟萃分析评估了使用GLP-1RA治疗的患者的胃肠道癌症风险。
方法:我们搜索了Medline/PubMed,Embase,和Scopus数据库从开始到2023年11月15日,用于随机对照试验(RCT),并进行至少24周的安全性随访。使用固定效应和随机效应模型计算集合风险比(RR)。使用修订后的Cochrane偏差风险工具评估偏差风险,证据的确定性是使用建议分级评估来确定的,发展,和评估(等级)框架。
结果:我们纳入了90项RCT,其中有124,791名参与者,每位参与者平均随访3.1年。GLP-1RAs与任何胃肠道癌症的风险之间没有发现显着关联(RR随机=0.99,95%CI:0.86-1.13),或特定部位的胃肠道癌症,包括胆道(RR=0.98,0.54-1.78),结直肠(RR=1.13,0.92-1.39),胆囊(RR=1.32,0.43-4.00),胃(RR=0.88,0.58-1.33),肝(RR=0.79,0.51-1.21),食管(RR=0.70,0.38-1.28),胰腺(RR=1.05,0.77-1.43),和小肠癌(RR=0.78,0.20-3.04)。相应的绝对风险差异排除了对风险的重要影响。其他分析,仅限于安慰剂对照试验,高剂量研究,或随访时间≥5年的人,证实了这些发现。所有结果的偏倚风险普遍较低,证据的确定性较高。
结论:这项荟萃分析发现GLP-1RA对胃肠道癌症风险没有显著影响。这些药物的长期安全监测仍然很重要。
背景:CRD42023476762.
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are commonly used for glucose lowering and weight-loss. However, their association with gastrointestinal cancer remains uncertain. This meta-analysis assesses the risk of gastrointestinal cancer in patients treated with GLP-1 RAs.
METHODS: We searched Medline/PubMed, Embase, and Scopus databases from inception to November 15, 2023, for randomized controlled trials (RCTs) with at least 24 weeks of safety follow-up. Pooled risk ratios (RRs) were calculated using fixed- and random-effect models. Risk of bias was assessed using the revised Cochrane risk-of-bias tool, and certainty of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.
RESULTS: We included 90 RCTs with 124,791 participants, with an average follow-up of 3.1 years per participant. No significant association was found between GLP-1 RAs and the risk of any gastrointestinal cancer (RRrandom=0.99, 95% CI: 0.86-1.13), or site-specific gastrointestinal cancers including biliary tract (RR=0.98, 0.54-1.78), colorectal (RR=1.13, 0.92-1.39), gallbladder (RR=1.32, 0.43-4.00), gastric (RR=0.88, 0.58-1.33), hepatic (RR=0.79, 0.51-1.21), oesophageal (RR=0.70, 0.38-1.28), pancreatic (RR=1.05, 0.77-1.43), and small intestine cancer (RR=0.78, 0.20-3.04). The corresponding absolute risk differences excluded important impacts on risk. Additional analyses, limited to placebo-controlled trials, high-dose studies, or those with a follow-up duration of ≥5 years, confirmed these findings. Risk of bias was generally low and the certainty of evidence was high for all outcomes.
CONCLUSIONS: This meta-analysis found no significant impact of GLP-1 RAs on gastrointestinal cancer risk. Long-term safety monitoring of these agents remains important.
BACKGROUND: CRD42023476762.