GLP-1 receptor agonists are associated with lower kidney cancer risk after metabolic bariatric surgery

Résumé fourni par la source

BACKGROUND: Kidney cancer (KC) is an obesity-related malignancy with rising incidence. Although metabolic and bariatric surgery (MBS) reduces the risk of some obesity-related cancers, the use of glucagon-like peptide-1 receptor agonists (GLP-1 RA) has increased after MBS; however, their association with KC risk remains unclear. We aimed to evaluate whether initiation of GLP-1 RA, compared with other glucose-lowering agents, is associated with KC among adults with prior MBS and type 2 diabetes (T2D), and overweight, or obesity. METHODS: We conducted a retrospective cohort study using TriNetX, applying an active-comparator, new-user target trial emulation framework. Adults (≥18 years) with T2D, obesity/overweight and prior MBS (2006-2025) were included, excluding those with prior cancer or type 1 diabetes. GLP-1 RA initiation was compared with metformin, insulin, sodium-glucose cotransporter 2 inhibitors (SGLT2i), or sulfonylureas. Time zero was the first post-MBS prescription after a 365-day washout. Propensity score matching (1:1) balanced baseline characteristics. The outcome was incident KC (ICD-10 C64, C65). Risk differences (RDs), and hazard ratios were estimated over 5 years. RESULTS: After matching, 16 768 GLP-1-metformin, 25 025 GLP-1-insulin, 8 613 GLP-1-SGLT2i, and 7 029 GLP-1-sulfonylurea pairs were included. GLP-1 RA initiation was associated with lower 5-year KC risk vs metformin (RD -0.18%; 95% CI -0.27 to -0.09), insulin (-0.22%; -0.30 to -0.15), SGLT2i (-0.19%; -0.34 to -0.04), and sulfonylureas (-0.20%; -0.37 to -0.03). Results were consistent across sensitivity analyses. CONCLUSIONS: Among post-MBS patients, GLP-1 RA initiation was associated with lower KC risk vs other therapies, supporting potential oncologic safety and benefits beyond glycemic control.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.