GLP-1 Based Therapies: Effects Beyond Blood Glucose Control
Long-term treatment of rodents with liraglutide is associated with thyroid C-cell hyperplasia and tumours. The GLP-1 receptor is highly expressed in the C-cells of rats and mice, whereas the expression of this receptor is low in humans. In a recent study, serum calcitonin levels were measured at 3-month intervals, for up to 2 years, in 5000 subjects receiving liraglutide or alternative therapy. There was no evidence of an increase in calcitonin due to the GLP-1 receptor agonist. There are no reported cases of medullary thyroid cancer following initiation of GLP-1 based therapy; however, caution is warranted in the use of these agents in patients with a history of thyroid cancer.
Thyroid C-cell Hyperplasia and GLP-1
Long-term treatment of rodents with liraglutide is associated with thyroid C-cell hyperplasia and tumours. The GLP-1 receptor is highly expressed in the C-cells of rats and mice, whereas the expression of this receptor is low in humans. In a recent study, serum calcitonin levels were measured at 3-month intervals, for up to 2 years, in 5000 subjects receiving liraglutide or alternative therapy. There was no evidence of an increase in calcitonin due to the GLP-1 receptor agonist. There are no reported cases of medullary thyroid cancer following initiation of GLP-1 based therapy; however, caution is warranted in the use of these agents in patients with a history of thyroid cancer.
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