Key takeaways:
- Use of GLP-1 receptor agonists (GLP-1RAs) for type 2 diabetes is associated with a reduced risk of venous thromboembolism (VTE).
- This reduction in risk applies regardless of whether patients have obesity.
At the 2024 ASH Annual Meeting and Exposition, researchers presented findings from a retrospective study showing that GLP-1RAs lower the risk of VTE among individuals with type 2 diabetes. These findings were consistent across patients with and without obesity, according to Cho Han Chiang, MD, junior medical resident at Mount Auburn Hospital.
Background and Study Design
VTE, affecting about 1 in 1,000 people in the U.S., is responsible for approximately 100,000 deaths annually. Over the past decade, its incidence has risen by 20%, noted study lead author Rushad Patell, MD, assistant professor at Harvard Medical School. Obesity is a significant risk factor for VTE, increasing risk by 2-3 times and contributing to 10% to 30% of cases.
GLP-1RAs, originally approved to manage type 2 diabetes, are also associated with weight loss, leading researchers to hypothesize that their weight loss effects might reduce VTE risk. Using the TriNetX Analytics Network—a database of over 250 million health records—researchers identified two matched cohorts of 168,428 patients each. One group was prescribed GLP-1RAs, and the other dipeptidyl peptidase-IV (DPP-IV) inhibitors, both targeting the incretin system to improve glycemic control.
The study’s primary endpoint was the incidence of VTE per 1,000 patient-years one year after treatment initiation. Secondary endpoints included rates of pulmonary embolism (PE) and deep vein thrombosis (DVT).
Findings and Implications
Patients in the GLP-1RA group showed a significantly lower incidence of VTE compared to the DPP-IV group (6.5 per 1,000 vs. 7.9 per 1,000; HR = 0.8; 95% CI, 0.75-0.85). A similar trend was observed for PE (HR = 0.78; 95% CI, 0.71-0.85) and DVT (HR = 0.82; 95% CI, 0.75-0.88).
Surprisingly, the reduced VTE risk was consistent regardless of obesity. “We initially expected greater VTE reduction in patients with obesity due to the weight loss effects of GLP-1RAs,” Chiang said. “However, the benefit observed in non-obese patients suggests mechanisms beyond weight loss may be involved.”
Future Directions
The findings require validation in prospective studies. Researchers also recommend exploring the effects of GLP-1RAs in broader populations, including those without diabetes, individuals using the drugs for weight loss, and patients at heightened VTE risk due to conditions like cardiovascular disease or cancer.
From a public health perspective, study authors highlighted the potential for GLP-1RAs to reduce the growing VTE burden on a population level. “As VTE incidence continues to rise, these drugs could help reverse that trend,” Patell said.
For further details, Cho Han Chiang, MD, can be contacted at chohan.chiang@mah.harvard.edu.
Funding and Disclosures:
The study was funded by the Conquer Cancer Foundation and the National Blood Clot Alliance. Patell disclosed consulting and personal fees from Merck Research. No relevant disclosures were reported by Chiang.
