Glucagon-like peptide 1 receptor agonists (GLP1-RAs) were associated with lower rates of venous thromboembolism (VTE) rates after one year in patients with type 2 diabetes mellitus. Authors of the study presented data at the ASH Annual Meeting that showed that the association was consistent regardless of obesity status.
GLP1-RAs are antihyperglycemic agents that were initially approved for the treatment of type 2 diabetes mellitus and then received approval for weight loss. Data have shown that the drugs also confer a cardiovascular benefit, but data have been limited to evaluation of atherosclerotic disease.
“Experimental studies have shown that GLP1-RAs may attenuate thromboxane-induced platelet activation. Moreover, obesity is an established risk factor for VTE. Given these observations, we hypothesized that GLP1-RA use may reduce the risk of VTE,” wrote the authors, led by Cho Han Chiang of Mount Auburn Hospital in Cambridge, Massachusetts.
The researchers conducted a retrospective study of data on 656,588 patients with type 2 diabetes mellitus, excluding those on oral anticoagulation, with prior VTE, or with a history of atrial fibrillation. They compared 366,369 patients on GLP1-RAs with 290,219 on dipeptidyl peptidase-4 (DPP-4) inhibitors, noting that “both of these medications target the incretin system and increase insulin secretion, thereby achieving glycemic control.” The researchers also matched the groups by using several clinical variables, including age, gender, BMI, other comorbidities, and other medications.
Incidence of VTE was 11.0 events per 1,000 patient-years in the GLP1-RA group versus 12.9 in the DPP-4 group. This represents an 18% lower risk of VTE with GLP1-RAs; the lower risk was similar in patients with or without obesity. Patients on GLP1-RAs also had a lower risk of pulmonary embolism and deep vein thrombosis.
“These results support the hypothesis that use of GLP1-RA can lead to a reduction in VTE risk. Further studies are needed to elucidate the mechanisms and causality underlying the association between GLP1-RA use and reduction of VTE risk, and whether these findings extend to patients using GLP1-RA for weight control without type 2 diabetes mellitus,” the authors concluded.
https://ash.confex.com/ash/2024/webprogram/Paper206409.html
Reference
Chiang CH, Osataphan S, Chang Y-C, et al. Glucagon-like peptide 1 receptor agonists reduce the risk of venous thromboembolism in patients with diabetes irrespective of obesity: a propensity score-matched multicenter database analysis. Abstract #701. Presented at the 66th American Society of Hematology Annual Meeting and Exposition, December 7–10, 2024, in San Diego, California.
