Thyroid Cancer – Pancreatitis Risks

Statement on the risk of thyroid cancer or pancreatitis from Saxenda or Ozempic

Glucagon-like Peptide 1 is a gut hormone that has numerous roles in the body, not least a central role in maintaining our sugar levels and also an important role in controlling our appetite and therefore weight.

However, ever since the early development of analogue versions of the GLP1, e.g. Exenatide and then Liraglutide, there has been speculation over whether they might increase the risks of conditions such as thyroid cancer and/or pancreatitis.

In rodents there is no doubt that liraglutide activates the GLP1 receptors on C-cells, causing an increased incidence of C-cell neoplasia (cancer). However, animal experiments with monkeys, demonstrated no increase in calcitonin and no C-cell proliferation even after long term liraglutide administration.

To date there has never been any proven link between liraglutide use in humans and an increased risk of thyroid cancer, although adverse event reporting from Exenetide data could not be conclusive and therefore at present it is not considered a major risk with this class of drug, but any history of medullary thyroid cancer remains a contraindication to their use.

Similarly, there has been concern over the risks of pancreatitis with the use of GLP1 analogues like Liraglutide. This has mainly been due to post-marketing reporting of adverse events rather than due to any proven cause and effect association.

In original studies in mice, there were a few cases of pancreatitis reported when given liraglutide, but there were also cases reported in the placebo group that were not given liraglutide, and so no conclusion could be made. In rat studies, there were no reported cases, and in monkey studies, neither pancreatitis nor any evidence or pre-cancerous changes were identified even after giving doses of GLP1 analogue that were equivalent to 60 times the human dose for 2 years.

Based on existing evidence there does not appear to be any proven risk of developing pancreatitis with the use of GLP1 analogues, and those cases reported may have occurred for other reasons. However, the known pre-existence of being susceptible to acute or chronic pancreatitis remains a contraindication to their use in humans.

Credit – Dr Matt Capehorn, and The National Medical Weight Loss Program