研究动态
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西光胰泰与癌症:系统综述与荟萃分析。

Semaglutide and cancer: A systematic review and meta-analysis.

发表日期:2023 Jul 26
作者: Lakshmi Nagendra, Harish Bg, Meha Sharma, Deep Dutta
来源: ARTHRITIS RESEARCH & THERAPY

摘要:

法国国家医疗保险系统数据库表明,使用类胰高血糖素样多肽-1受体激动剂(GLP-1RA)(exenatide、liraglutide和dulaglutide)1-3年可能与甲状腺癌发生率增加有关。关于semaglutide的类似数据目前不可得。因此,我们进行了这项系统回顾,以研究semaglutide的安全性,重点关注不同类型的癌症。我们搜索了涉及接受干预性semaglutide治疗的患者的随机对照试验(RCTs)和实际世界研究的数据库。主要结果是评估胰腺和甲状腺癌的发生情况。次要结果是评估其他任何恶性肿瘤或严重不良事件的发生情况。我们分析了37个RCTs和19个实际世界研究的数据,其中安慰剂对照组有16,839名患者,活性对照组有16,550名患者,实际世界研究组有13,330名患者。与安慰剂相比,semaglutide组的胰腺癌[OR 0.25(95%CI: 0.03-2.24);P = 0.21]、甲状腺癌[OR 2.04(95%CI: 0.33-12.61); P = 0.44; I2 = 0%]和所有肿瘤(良性、恶性和其他未指明)[OR 0.95(95%CI:0.62-1.45); P = 0.82; I2 = 0%]发生率相似。与活性对照组相比,semaglutide组的胰腺癌[OR 0.40(95%CI:0.09-1.87); P = 0.26; I2 = 0%]、甲状腺癌[OR 1.19(95%CI:0.15-9.66); P = 0.87; I2 = 0%]和所有肿瘤(良性、恶性和其他未指明)[OR 0.91(95% CI: 0.44-1.89); P = 0.79; I2 = 0%]发生率相似。实际世界数据分析显示了胰腺癌和B细胞淋巴瘤各一例。RCTs和实际世界研究中semaglutide的使用与任何类型的癌症风险增加无关,并且这一结论得到了很高的证据级别支持。版权所有 © 2023年 Elsevier出版。
French national health care insurance system database has suggested 1-3 years use of glucagon like peptide-1 receptor agonists (GLP1RA) (exenatide, liraglutide and dulaglutide) may be linked with increased occurrence of thyroid cancer. Similar data on semaglutide is not-available. Hence, we undertook this systematic review to look at the safety of semaglutide focussing on different cancers.Databases were searched for randomized controlled trials (RCTs) and real-world studies involving patients receiving semaglutide in the intervention-arm. Primary outcome was to evaluate the occurrence of pancreatic and thyroid cancers. Secondary outcomes were to the evaluate occurrence of any other malignancies or severe adverse-events.Data from 37 RCTs and 19 real-world studies having 16,839 patients in placebo-control group, 16,550 patients in active-control group and 13,330 patients in real-world studies were analysed. Compared to placebo, occurrence of pancreatic cancer [OR 0.25 (95%CI: 0.03-2.24); P = 0.21], thyroid cancer [OR 2.04 (95%CI: 0.33-12.61); P = 0.44; I2 = 0%] and all neoplasms (benign, malignant and otherwise unspecified) [OR 0.95 (95%CI:0.62-1.45); P = 0.82; I2 = 0%] was similar in the semaglutide group. Compared to active controls, occurrence of pancreatic cancer [OR 0.40 (95%CI:0.09-1.87); P = 0.26; I2 = 0%], thyroid cancer [OR 1.19 (95%CI:0.15-9.66); P = 0.87; I2 = 0%] and all neoplasms (benign, malignant and otherwise unspecified) [OR 0.91 (95% CI: 0.44-1.89); P = 0.79; I2 = 0%] were similar in the semaglutide group. Real-world data analysis revealed single case each of pancreatic cancer and B-cell lymphoma.Semaglutide use in RCTs and real-world studies was not associated with an increased risk of any types of cancer, and this conclusion is supported by a high grade of evidence.Copyright © 2023. Published by Elsevier Ltd.