Evidence map›Paper›PMID 40832397›Full record

ArticlemedRxiv : the preprint server for health sciences2025

Phenome-Wide Risk Evaluation of GLP-1 Receptor Agonist Use in Type 2 Diabetes with Real-World Data Across Multiple Healthcare Systems.

Rohit Vashisht, Sanket S Dhruva, Ayan Patel, Lisa Dahm, Pagan Morris, David Gonzalez, Rob Follett, Marina Sirota, Karandeep Singh, Cora Han and 2 more

Abstract readPreprint
PubMed Full text at PMC Publisher
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Rohit VashishtBakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA.ORCID 0000-0002-2938-7259
Sanket S DhruvaSection of Cardiology, Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Ayan PatelBakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA.
Lisa DahmCenter for Data-driven Insights and Innovation, University of California Health, Oakland.
Pagan MorrisCenter for Data-driven Insights and Innovation, University of California Health, Oakland.
David GonzalezCenter for Data-driven Insights and Innovation, University of California Health, Oakland.
Rob FollettCenter for Data-driven Insights and Innovation, University of California Health, Oakland.
Marina SirotaBakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA.
Karandeep SinghDigital Health Innovation, University of California San Diego Health, San Diego.
Cora HanCenter for Data-driven Insights and Innovation, University of California Health, Oakland.
Suneil KoliwadDivision of Endocrinology and Metabolism, University of California-San Francisco, San Francisco, CA, USA.
Atul J ButteBakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA.

Funding

Clinical and Translational Science InstituteUL1TR001872 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI COLLARD, HAROLD R, JACOBY, VANESSA · 2016 to 2025
$112.1M
FDA HHS U01 FD005978NCATS NIH HHS UL1 TR001872
6 · The paper itself

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1RAs), widely used for managing type 2 diabetes (T2D) and weight, are gaining attention for treatment of a broad set of conditions. Large-scale, real-world evidence of their broader clinical impact is needed. We assessed the phenome-wide risks and benefits of new users of GLP-1RA versus sulfonylureas, SGLT-2 inhibitors (SGLT-2i), and DPP-4 inhibitors (DPP-4i) in adults with T2D in a multi-healthcare center, 1:1 high-dimensional propensity score matched new user cohort study utilizing principles of target trial emulation with electronic health records (EHRs) of over 9 million patients followed up to 730 days. Primary outcomes included 239 clinical endpoints across 14 organ systems. Among 86,790 patients, mean age was 58-66 years and 44-62% were female across cohorts. Compared to DPP-4i, GLP-1RA use was associated with a reduced risk of acute myocardial infarction (sHR 0.61, 95% CI 0.43-0.85) and chronic kidney disease (sHR 0.71, 95% CI 0.62-0.81). Compared to sulfonylurea, GLP-1RA use was associated with reduced acute renal failure risk (sHR 0.77, 95% CI 0.65-0.90). GLP-1RA use was associated with reduced heart failure risk compared to SGLT-2i (sHR 0.66, 95% CI 0.55-0.80). GLP-1RA also was associated with lower epilepsy risk versus DPP-4i (sHR 0.49, 95% CI 0.32-0.76). GLP1RA was associated with elevated risks of nausea/vomiting: sHR 1.37 vs SGLT2i, 95% CI 1.15-1.62; sHR 1.46 vs sulfonylureas, 95% CI 1.24-1.71). Head-to-head real-world comparisons with established T2D therapies confirmed the broad cardiorenal and metabolic benefits and known on-target adverse effects of GLP-1RAs -consistent with randomized clinical trials - but also suggest potential risks for musculoskeletal and genitourinary adverse events, warranting continued real-world post-market surveillance.

Identifiers

PMID40832397
PMCPMC12363721

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.