GLP-1 Receptor Agonists and Risk of Skin Cancer in Adults With Type 2 Diabetes: A Target Trial Emulation.
GLP-1 drugs linked to slightly higher non-melanoma skin cancer risk vs SGLT2 inhibitors
GLP-1 Receptor Agonists and Risk of Skin Cancer in Adults With Type 2 Diabetes: A Target Trial Emulation.
Existing evidence regarding the association between glucagon-like peptide-1 receptor agonists (GLP-1RAs) and risk of melanoma and non-melanoma skin cancer (non-melanoma skin cancer) is inconclusive.
This study aimed to assess the association between GLP-1RA initiation and risks of melanoma and non-melanoma skin cancer versus sodium-glucose cotransporter 2 inhibitors (SGLT2is) and dipeptidyl peptidase 4 inhibitors (DPP4is) in adults with type 2 diabetes (T2D).
Target trial emulation using TriNetX electronic health records (2014-2025).
6% higher rate of non-melanoma skin cancer with GLP-1 drugs versus SGLT2 inhibitors; effect faded after bias correction.
After matching, the GLP-1RA versus SGLT2i cohort included 235 797 pairs; the GLP-1RA versus DPP4i cohort included 153 873 pairs.
GLP-1RA use was not associated with melanoma compared with either SGLT2i (HR, 1.04; 95% CI, 0.93-1.17) or DPP4i (HR, 1.09; 95% CI, 0.95-1.25).
Findings were generally consistent across sensitivity analyses; however, the association with non-melanoma skin cancer was attenuated after negative control outcome calibration.
GLP-1RA therapy was not associated with an increased risk of melanoma. A borderline increase in non-melanoma skin cancer risk was observed compared with SGLT2is but was not evident after negative control outcome calibration.