Incretin Therapies and Thyroid Cancer Risk: GLP-1 Drugs vs DPP-4 Inhibitors Compared

Analysis investigated the association between incretin-based therapies (GLP-1 agonists and DPP-4 inhibitors) and thyroid cancer, comparing risk profiles between the two drug classes.

Acheampong, Clement O et al.·BMJ open diabetes research & care·2025·Moderate Evidencecohort
RPEP-09760CohortModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
cohort
Evidence
Moderate Evidence
Sample
N=N/A
Participants
U.S. Medicare beneficiaries with type 2 diabetes using incretin-based or SGLT-2 inhibitor therapies

What This Study Found

Comparative analysis of thyroid cancer associations between GLP-1 agonists and DPP-4 inhibitors provides class-specific risk data for incretin-based therapies.

Key Numbers

Study used thyroidectomy + 2 or more separate thyroid cancer diagnosis codes as the definition of thyroid cancer. U.S. Medicare population with type 2 diabetes.

How They Did This

Analysis comparing thyroid cancer incidence between GLP-1 receptor agonist and DPP-4 inhibitor users.

Why This Research Matters

Distinguishing thyroid cancer risk between GLP-1 drugs and DPP-4 inhibitors informs safer prescribing choices, especially for patients with thyroid concerns.

The Bigger Picture

This comparative approach is valuable because GLP-1 drugs and DPP-4 inhibitors raise GLP-1 signaling through different mechanisms. If thyroid risk differs between classes, it reveals whether the concern is about GLP-1 receptor activation level, duration, or a drug-specific property.

What This Study Doesn't Tell Us

Observational data with potential confounders. Thyroid cancer is rare, limiting statistical power. Different patient populations may use different drug classes.

Questions This Raises

  • ?Is the thyroid cancer signal stronger with GLP-1 drugs than DPP-4 inhibitors?
  • ?Does the level of GLP-1 receptor activation correlate with thyroid risk?
  • ?Should thyroid cancer history influence the choice between GLP-1 drugs and DPP-4 inhibitors?

Trust & Context

Key Stat:
Class comparison Thyroid cancer risk compared between GLP-1 agonists and DPP-4 inhibitors to determine if risk is class-specific or shared across incretin therapies
Evidence Grade:
Moderate evidence: comparative observational analysis of a clinically important safety question.
Study Age:
Published in 2025. Addresses ongoing thyroid safety concerns with incretin drugs.
Original Title:
Investigating the association between incretin-based therapies and thyroid cancer incidence among US Medicare beneficiaries with diabetes.
Published In:
BMJ open diabetes research & care, 13(5) (2025)
Database ID:
RPEP-09760

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study
What do these levels mean? →

Frequently Asked Questions

Which is safer for my thyroid: GLP-1 drugs or DPP-4 inhibitors?

This study compared thyroid cancer associations between the two classes. GLP-1 drugs carry a boxed warning from rodent data, while DPP-4 inhibitors do not. The comparative analysis helps clarify whether this risk difference is real in humans.

Should I avoid GLP-1 drugs if I have thyroid issues?

GLP-1 drugs should be avoided if you have personal or family history of medullary thyroid cancer or MEN2 syndrome. For other thyroid conditions, discuss with your endocrinologist — the risk in humans appears very low based on current evidence.

Read More on RethinkPeptides

Cite This Study

RPEP-09760·https://rethinkpeptides.com/research/RPEP-09760

APA

Acheampong, Clement O; Buse, John B; Klein, Klara R; Kim, Lawrence T; Evron, Joshua; Kahkoska, Anna R; Thompson, Caroline A; Wang, Tiansheng; Pate, Virginia; Leese, Peter; Stürmer, Til. (2025). Investigating the association between incretin-based therapies and thyroid cancer incidence among US Medicare beneficiaries with diabetes.. BMJ open diabetes research & care, 13(5). https://doi.org/10.1136/bmjdrc-2025-005090

MLA

Acheampong, Clement O, et al. "Investigating the association between incretin-based therapies and thyroid cancer incidence among US Medicare beneficiaries with diabetes.." BMJ open diabetes research & care, 2025. https://doi.org/10.1136/bmjdrc-2025-005090

RethinkPeptides

RethinkPeptides Research Database. "Investigating the association between incretin-based therapi..." RPEP-09760. Retrieved from https://rethinkpeptides.com/research/acheampong-2025-investigating-the-association-between

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkPeptides research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.