The following is a summary of “Association between incretin-based drugs and risk of cholangiocarcinoma among patients with type 2 diabetes: A large population-based matched cohort study,” published in the December 2024 issue of Endocrinology by Krishnan et al. 

Researchers conducted a retrospective study to investigate the association between incretin-based drug use (glucagon-like peptide-1 receptor agonists [GLP-1RAs] and dipeptidyl peptidase-4 inhibitors [DPP-4Is]) and the risk of cholangiocarcinoma (CCA) in the United States.  

They used the TriNetX datasets to include adult patients with type 2 diabetes mellitus (T2DM) who were new users of GLP-1RAs, DPP-4Is, or other second- or third-line antidiabetic drugs between 2010 and 2021. The primary outcome calculated was the incidence of CCA.  

The results showed that 38,16,071 patients were included (mean age, 61.4 years; female, 49.3%). The GLP-1RAs and DPP-4Is were associated with a 51% and 23% reduction in CCA risk after 1 year (hazard ratio 0.49; 95% CI 0.40–0.60 for GLP-1RAs and 0.77; 95% CI 0.67–0.90 for DPP-4Is) compared to second- or third-line antidiabetic drug users. This trend remained consistent over 3, 5, and 7 years of follow-up (0.66, 0.71, and 0.72 for GLP-1RAs; 0.84, 0.87, and 0.85 for DPP-4Is). The GLP-1RA use was linked to a 42% lower CCA risk compared to metformin, while DPP-4I use showed no increased risk.  

Investigators concluded that GLP-1RAs and DPP-4Is were not associated with an increased risk of CCA, with GLP-1RAs even demonstrating a possible reduced risk, suggesting they could be considered safe and effective treatment options for patients with T2DM at risk of CCA. 

Source: sciencedirect.com/science/article/pii/S2214623724000413