Two recent studies suggest that GLP-1RAs, which have pleiotropic effects on lowering plasma glucose, inducing weight loss, and modulating immune functions, also confer other benefits, including lowering for colorectal cancer (CRC) risks and reducing alcohol cravings.
A research letter published in the Journal of the American Medical Association Oncology posited that GLP-1RAs are associated with a decreased risk for CRC in patients with T2D compared with non–GLP-1RA antidiabetics. The team from Case Western Reserve University School of Medicine explained that was because overweight/obesity is a major risk factor for CRC.
To test the hypothesis, the researchers conducted a nationwide, retrospective cohort study among drug-naïve patients with T2D comparing GLP-1RAs with 7 non–GLP-1RA glucose-lowering agents, including metformin and insulin, which have been suggested to influence CRC risk.
The study included 7.4 million patients with T2D from 59 healthcare organizations across 50 states, pulled from the TriNetX platform. Of those, 1.2 million T2D patients had been prescribed antidiabetic medications after medical encounters from 2005 to 2019, had no prior antidiabetic medication use (drug naïve), and were without prior CRC diagnosis.
The study team compared GLP-1RAs with insulin, metformin, alpha-glucosidase inhibitors, dipeptidyl-peptidase 4 (DPP-4) inhibitors, sodium-glucose cotransporter-2 (SGLT2) inhibitors, sulfonylureas, and thiazolidinediones. The study period—2005 to 2019 (except for the starting year of 2013 for SGLT2 inhibitors and 2006 for DPP-4 inhibitors)—was based on the year drugs were first approved. The study population was divided into exposure and comparison cohorts for each comparison.
During the 15-year follow-up, the results indicated that GLP-1RAs were associated with a decreased risk for CRC compared with insulin (HR, 0.56; 95% CI, 0.44-0.72), metformin (HR, 0.75; 95% CI, 0.58-0.97), SGLT2 inhibitors, sulfonylureas, and thiazolidinediones, and with lower (but not statistically significant) risk compared with alpha-glucosidase or DPP-4 inhibitors.
The authors added that consistent findings were observed in women and men, explaining that GLP-1RAs were associated with a lower risk for CRC in patients with obesity/overweight compared with insulin (HR, 0.50; 95% CI, 0.33-0.75), metformin (HR, 0.58; 95% CI, 0.38-0.89), or other antidiabetics.
“In this cohort study, GLP-1RAs were associated with reduced CRC risk in drug-naive patients with T2D with and without obesity/overweight, with more profound effects in patients with obesity/overweight, suggesting a potential protective effect against CRC partially mediated by weight loss and other mechanisms not related to weight loss,” the study concluded.
The other study was an analysis of social media posts on the community network Reddit where users reported reduced cravings for alcohol when taking drugs intended to treat T2D and obesity.
Virginia Tech researchers analyzed those posts, together with a remote study of individuals with obesity who reported using semaglutide and tirzepatide. Their findings were published in Scientific Reports.
“These findings add to a growing literature that these medications may curb dangerous drinking habits,” explained Warren Bickel, Virginia Tech Carilion Behavioral Health Research Professor at the Fralin Biomedical Research Institute at VTC and corresponding author.
The study team analyzed more than 68,000 Reddit posts from 2009 to 2023 that included terms linked to GLP-1 approved medications. Ultimately, they found that 962 individuals created 1,580 alcohol-related posts, and, of those, 71.7% addressed reduced cravings, reduced usage, and other negative effects due to drinking.
In a second study, the team recruited 153 participants who self-reported having obesity from various social media platforms. Participants on semaglutide or tirzepatide reported drinking significantly fewer drinks on average compared with those in the control group who were not on any medication for diabetes or weight loss.
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