ORLANDO, FL — Glucagon-like peptide-1 receptor agonists (GLP-1RA) are widely used for the management of diabetes mellitus and obesity, but is there a link between their use and a greater risk of hematologic malignancies?
Noting that the issue has been relatively underexplored, researchers from the University of Central Florida and the Orlando VA Healthcare Center sought to answer that question. To do that, they conducted a retrospective cohort study using VA national data, including patients with diabetes initiating GLP-1RA or dipeptidyl peptidase-4 inhibitors (DPP-4i), as active comparators, during 2006 to 2021. An active comparator, new-user design was used, and propensity score matching was performed using 71 baseline covariates. The primary outcome was defined as an incident diagnosis of Hodgkin lymphoma, non-Hodgkin lymphoma, leukemias, or multiple myeloma. Results were published in Clinical Lymphoma, Myeloma & Leukemia.1
Among 409,334 eligible patients with diabetes, 100,038 matched pairs were included. In the propensity score-matched cohort, incidence of our outcomes in DPP4i users versus GLP-1RA users were as follows:
- Hodgkin lymphoma 36 (0.04%) vs. 32 (0.03%) (odds ratio [OR]: 0.89; 95% confidence interval [CI]: 0.55-1.43; P = 0.63),
- Non-Hodgkin lymphoma 260 (0.3%) vs. 253 (0.3%) (OR: 0.97; 95% CI, 0.82-1.16; P = 0.76),
- Leukemias 258 (0.3%) vs. 248 (0.3%) (OR: 0.96; 95% CI, 0.81-1.14; P = 0.66), and
- Multiple myeloma 126 (0.1%) vs. 115 (0.1%) (OR: 0.91; 95% CI, 0.71-1.18; P = 0.48), respectively.
Findings were consistent across most subgroup analyses by duration of therapy, baseline body mass index and weight change, the researchers advised.
“In this large national cohort of veterans with diabetes, GLP-1RA use was not associated with an increased or decreased risk of hematologic malignancies compared to DPP-4i,” the authors concluded.
- Ramos S, Zaw S, Carilli A, Mansi IA. Association of GLP1-Receptor Agonists With Risk of Hematologic Malignancies in People With Diabetes. Clin Lymphoma Myeloma Leuk. 2026 Jun 18:S2152-2650(26)00180-1. doi: 10.1016/j.clml.2026.06.007. Epub ahead of print. PMID: 42471299.
