title: Tumour Risk with Once-Weekly Glucagon-Like Peptide-1 Receptor Agonists in Type 2 Diabetes Mellitus Patients: A Systematic Review.
abstract: OBJECTIVE
  Once-weekly glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a novel class of injectable antidiabetic drugs. Previous studies indicated that GLP-1RAs (exenatide and liraglutide) might increase the incidence of pancreatitis and pancreatic cancer. Here, we evaluated the clinical safety of once-weekly GLP-1RAs with respect to tumour risk.
  
  
  METHODS
  Relevant studies were selected from ClinicalTrials.gov. Randomized controlled trials that reported the incidences of neoplasms were included in our research. Outcomes were calculated as the risk ratio using the Mantel-Haenszel method and fixed-effects model.
  
  
  RESULTS
  Our analysis included 26 randomized controlled trials with 16,090 patients. Once-weekly GLP-1RAs did not increase the risk for tumours compared with other antidiabetic drugs [risk ratio (RR), 1.02; 95 % confidence interval (CI), 0.74-1.41; p = 0.91]; this finding was independent of the type of GLP-1RA administered (albiglutide, exenatide extended-release and dulaglutide) and duration of the trials (limited to ≥52 weeks). Subgroup analyses revealed that once-weekly GLP-1RAs did not increase tumour risk compared with placebos, exenatide and liraglutide, insulin or oral drugs. Additionally, once-weekly GLP-1RAs did not increase tumour risk in any tissue.
  
  
  CONCLUSIONS
  Compared with other antidiabetic drugs, once-weekly GLP-1RAs did not increase the risk for any tumour, and this finding was independent of the type of GLP-1RA administered and treatment duration. However, our study had many limitations, and further longer term trials with larger samples should be conducted in future to confirm our results.
authors.affiliation: Intensive Care Unit, Tengnan Hospital of Zaozhuang Mining Group, Shandong, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Guo
authors.affiliation: Department of Medicine, Maternal and Child Care Service Centre of Tengzhou City, Shandong, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Department of Medicine, East Campus, Qilu Hospital, Shandong, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Dong
authors.affiliation: Department of Endocrinology, Qianfoshan Hospital of Shandong University, Shandong, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Liao
authors.affiliation: Division of Endocrinology and Diabetology, Department of Internal Medicine II, University Hospital of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Division of Endocrinology and Diabetology, Department of Internal Medicine II, University Hospital of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany. Liufupengsdu@126.com.|Department of Endocrinology, Tengzhou Central People's Hospital, Shandong, China. Liufupengsdu@126.com.
authors.forename: Fupeng
authors.initials: F
authors.lastname: Liu
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D009369:Neoplasms / Q000139:chemically induced* / Q000453:epidemiology*; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
chemical_list: D007004:Hypoglycemic Agents; D000097789:Glucagon-Like Peptide-1 Receptor Agonists