Retrospective cohort study of GLP-1 RA prescribing in patients with type 2 diabetes and cancer

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used to treat type 2 diabetes (T2D), yet little is known about its utilization in patients with cancer history, given limited oncology-specfic guidance. A retrospective cohort study evaluated trends and factors associated with GLP-1 RA use among Medicare beneficiaries, comparing those with and without cancer history. The study enrolled patients diagnosed with 7 common cancers between 2010 and 2021, and preexisting T2D before cancer diagnosis, with follow-up through 2022. In this cohort study of 373 278 Medicare beneficiaries, GLP-1 RA use inreased more than 16-fold from 2010 to 2022. Despite higher observed use among beneficiaries with cancer, difference were attenuated after accounting for comorbidities and complications that typically characterize GLP-1 RA use in the general T2D population, and use was lower in beneficiaries with colorectal or pancreatic cancer and those with advanced-atage disease. The authors conclude that these findings suggest that GLP-1 RA prescribing was primarily associated with metabolic risk profile, with limited differences by cancer history, although variaton across cancer types and stages suggests oncological context may influence prescribing.