Evidence map›Paper›PMID 42745130›Full record

ArticleJournal of gastrointestinal cancer2026

Long-Term Association Between GLP-1 Receptor Agonist Use and Incident Pancreatic Cancer: A Propensity Score-Matched Retrospective Cohort Study Using the TriNetX Network.

Muhammad Ali Ibrahim Kazi, Junaid Khan, Syed Musa Mufarrih, Maham Siddiqui, Huzaifa Ul Haque Ansari, Muhammad Ahmed, Imran Qureshi, Abdulhameed Al-Sabban, Nihaal Prashant Karnik, Andrew Gilman and 2 more

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Article in Journal of gastrointestinal cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Muhammad Ali Ibrahim KaziAnne Arundel Medical Center, Annapolis, MD, USA.
Junaid KhanAnne Arundel Medical Center, Annapolis, MD, USA.
Syed Musa MufarrihAga Khan University Karachi, Karachi, Pakistan.
Maham SiddiquiAnne Arundel Medical Center, Annapolis, MD, USA.
Huzaifa Ul Haque AnsariDow University of Health Sciences, Karachi, Pakistan.
Muhammad AhmedDow University of Health Sciences, Karachi, Pakistan.
Imran QureshiDepartment of Gastroenterology, University of Pittsburgh Medical Center, Pittsburg, PA, USA. qureshiia@upmc.edu.
Abdulhameed Al-SabbanDivision of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, MD, USA.
Nihaal Prashant KarnikGeisinger Health System, Danville, PA, USA.
Andrew GilmanDivision of Gastroenterology and Hepatology, University of California, Davis, CA, USA.
Sanmeet SinghAnne Arundel Medical Center, Annapolis, MD, USA.
Andrew CanakisDivision of Gastroenterology and Hepatology, TidalHealth Peninsula Regional Medical Center, Salisbury, MD, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGlucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely prescribed for type 2 diabetes mellitus (T2DM) and obesity. Whether GLP-1 RA use is associated with altered long-term pancreatic cancer risk remains uncertain, with conflicting evidence from prior observational studies. We aimed to evaluate the association between initiation of GLP-1 RA therapy and incident pancreatic cancer risk compared with six classes of antidiabetic agents.

methodsWe conducted a retrospective, new-user cohort study using the TriNetX global federated electronic health record network. Adults with T2DM initiating GLP-1RA therapy were compared with incident users of insulin, metformin, dipeptidyl peptidase-4 (DPP-4) inhibitors, sodium-glucose cotransporter-2 (SGLT2) inhibitors, sulfonylureas, and thiazolidinediones in six separate propensity score-matched analyses (1:1, greedy nearest-neighbor algorithm, caliper 0.1 pooled standard deviations). Matching was performed on 39 baseline covariates,, including demographics, comorbidities, procedures, and medication exposures. The primary outcome was incident pancreatic cancer (ICD-10-CM C25) occurring between 365 and 7,300 days after the index prescription. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression.

resultsAfter propensity score matching, GLP-1 RA users compared with insulin users had a lower hazard of pancreatic cancer (HR 0.43, 95% CI 0.35, 0.53; absolute risk: GLP-1 RA 0.15% vs. insulin 0.11%; absolute risk difference [ARD] 0.04% points). In contrast, users of metformin (HR 1.39, 95% CI 1.16, 1.66; ARD 0.04% points), sulfonylureas (HR 1.37, 95% CI 1.13, 1.65; ARD 0.07% points), thiazolidinediones (HR 1.30, 95% CI 1.001, 1.678; ARD 0.15% points) and DPP-4i (HR 1.31; 95% CI 1.06, 1.61; ARD 0.08% points) had significantly higher hazards of pancreatic cancer compared with GLP-1 RA users. No significant difference was observed between GLP-1 RA users and users of SGLT2 inhibitors (HR 1.08, 95% CI 0.87, 1.34).

conclusionsIn this large, real-world, propensity score-matched analysis, the direction and magnitude of the association between GLP-1 RA use and pancreatic cancer risk varied by comparator agent. GLP-1 RA use was associated with a lower hazard of pancreatic cancer relative to metformin, sulfonylureas, thiazolidinediones, and DPP-4i while no significant difference relative to SGLT2i, and a higher hazard relative to insulin.

Indexed as

Diabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsPancreatic NeoplasmsAgedFemaleHumansIncidenceInsulin SecretagoguesMaleMetforminMiddle AgedPropensity ScoreRetrospective StudiesSulfonylurea CompoundsGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsInsulin SecretagoguesMetforminSulfonylurea CompoundsGLP-1 receptor agonistsIncretin therapyPancreatic cancerPharmacoepidemiologyPropensity score matchingTriNetXType 2 diabetes mellitus

Identifiers

PMID42745130

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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.