Pre-Diagnosis GLP-1 Receptor Agonist Use and Post-Cancer Mortality in Adults With Obesity and Type 2 Diabetes

Chung Shan Medical University203,424 enrolled

Overview

This study will examine whether the type of diabetes treatment used before cancer diagnosis is associated with survival and serious complications after obesity-associated cancer in adults with obesity and type 2 diabetes. The study focuses on glucagon-like peptide-1 receptor agonists (GLP-1 RA) and compares them with other commonly used glucose-lowering therapies, including SGLT2 inhibitors, DPP-4 inhibitors, sulfonylureas, metformin, and usual care. Using de-identified electronic health record data from the TriNetX US Collaborative Network, the study will assess whether patients who used GLP-1 RA before cancer diagnosis have different risks of death, hospitalization, sepsis, and other major outcomes after cancer diagnosis. This is an observational study designed to evaluate associations in routine clinical care and not to prove a treatment effect.

Study Type

OBSERVATIONAL

Enrollment

203,424

Conditions

Obesity & Overweight Diabetes Mellitus Type 2 Neoplasms

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults aged 18 years or older * BMI ≥27 kg/m2, or diagnosis codes consistent with obesity * Type 2 diabetes mellitus * Initiation of a glucose-lowering medication before obesity-associated cancer diagnosis * Incident obesity-associated cancer diagnosed after medication initiation * No dispensing of the study drug class during the 6-month washout period before the first qualifying prescription Exclusion Criteria: * Type 1 diabetes mellitus, Other specified diabetes types that are not type 2 diabetes * Human immunodeficiency virus infection * End-stage renal disease * Prior bariatric surgery * Prior organ transplantation * Transplant-related complications * Any use of tirzepatide before cohort entry

Locations (1)

Chung Shan Medical University Hospital

Taichung, Taichung City, Taiwan

Outcomes

Primary Outcomes

All-cause Mortality (Comparison 1)

All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.