Article type
Year
Abstract
Background: According to the International Diabetes Federation in 2013, 387 million people are currently diagnosed with diabetes, and it is projected that this figure will rise to 592 million people worldwide living with diabetes by the year 2035. An increasing number of patients with type 2 diabetes mellitus (T2DM) are being treated with glucagon-like peptide-1 receptor agonists (GLP-1 RAs). However, some studies reported that GLP-1 could increase the incidence of cancer, so there is a need to assess the impact of GLP-1 on cancer.
Objectives: To synthesize current evidence of the impact of GLP-1 RAs on cancer in patients with T2DM.
Methods: The Cochrane Library, Embase, MEDLINE and Clinical Trials were searched from inception through June 2015 to identify RCTs that assessed the safety of GLP-1 RAs versus placebo or other antidiabetic drug(s) in T2DM. Odds ratios (OR) with 95% confidence intervals (CI) were estimated through network meta-analysis. Ranking probabilities for all treatments were estimated to obtain a treatment hierarchy using the surface under the cumulative ranking curve (SUCRA) and mean ranks.
Results: We included 21 trials with 10 treatments (albiglutide, dulaglutide, exenatide, exenatide long-acting release (LAR), insulin, liraglutide, sulphonylureas (SU), sitagliptin, thiazolidinedione (TZD) and placebo). Overall, no statistically significant difference was found between GLP-1 RAs versus placebo or other antidiabetic drugs. However, the results did indicate something. Compared with placebo, albiglutide decreased the risk of cancer. Reduction in the incidence of cancer was found for albiglutide and exenatide versus insulin and sitagliptin. All GLP-1 RAs decreased the risk of cancer when compared with TZD. Finally, according to SUCRAs, SU and exenatide decrease the incidence of cancer most, while exenatide LAR and TZD had the highest risk of incidence of cancer.
Conclusions: From the 10 treatments investigated, SU and exenatide decrease the incidence of cancer most.
Objectives: To synthesize current evidence of the impact of GLP-1 RAs on cancer in patients with T2DM.
Methods: The Cochrane Library, Embase, MEDLINE and Clinical Trials were searched from inception through June 2015 to identify RCTs that assessed the safety of GLP-1 RAs versus placebo or other antidiabetic drug(s) in T2DM. Odds ratios (OR) with 95% confidence intervals (CI) were estimated through network meta-analysis. Ranking probabilities for all treatments were estimated to obtain a treatment hierarchy using the surface under the cumulative ranking curve (SUCRA) and mean ranks.
Results: We included 21 trials with 10 treatments (albiglutide, dulaglutide, exenatide, exenatide long-acting release (LAR), insulin, liraglutide, sulphonylureas (SU), sitagliptin, thiazolidinedione (TZD) and placebo). Overall, no statistically significant difference was found between GLP-1 RAs versus placebo or other antidiabetic drugs. However, the results did indicate something. Compared with placebo, albiglutide decreased the risk of cancer. Reduction in the incidence of cancer was found for albiglutide and exenatide versus insulin and sitagliptin. All GLP-1 RAs decreased the risk of cancer when compared with TZD. Finally, according to SUCRAs, SU and exenatide decrease the incidence of cancer most, while exenatide LAR and TZD had the highest risk of incidence of cancer.
Conclusions: From the 10 treatments investigated, SU and exenatide decrease the incidence of cancer most.