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GLP-1 Receptor Agonist Use and Risk of Suicide Death
Importance: Concerns have been raised regarding a link between use of glucagon-like peptide-1 (GLP-1) receptor agonists and increased risk of suicidality and self-harm. Objective: To assess the association between use of GLP-1 receptor agonists and the risk of suicide death in routine clinical practice. Design, Setting, and Participants: This active-comparator new-user cohort study used nationwide register data from Sweden and Denmark from 2013 to 2021. Adults 18 to 84 years old who initiated treatment with GLP-1 receptor agonists or the comparator sodium-glucose cotransporter-2 (SGLT2) inhibitors were included. Data were analyzed from March to June 2024. Exposure: Initiation of treatment with a GLP-1 receptor agonist or SGLT2 inhibitor. Main Outcomes and Measures: The primary outcome was suicide death recorded in the cause of death registers. Secondary outcomes were the composite of suicide death and nonfatal self-harm and the composite of incident depression and anxiety-rel ated disorders. Using propensity score weighting, hazard ratios (HRs) with 95% CIs were calculated separately in the 2 countries and pooled in a meta-Analysis.
Results: In total, 124517 adults initiated a GLP-1 receptor agonist and 174036 initiated an SGLT2 inhibitor; among GLP-1 receptor agonist users, the mean (SD) age was 60 (13) years, and 45% were women. During a mean (SD) follow-up of 2.5 (1.7) years, 77 suicide deaths occurred among users of GLP-1 receptor agonists and 71 suicide deaths occurred among users of SGLT2 inhibitors: weighted incidences were 0.23 vs 0.18 events per 1000 person-years (HR, 1.25; 95% CI, 0.83-1.88), with an absolute difference of 0.05 (95% CI,-0.03 to 0.16) events per 1000 person-years. The HR was 0.83 (95% CI, 0.70-0.97) for suicide death and nonfatal self-harm, and the HR was 1.01 (95% CI, 0.97-1.06) for incident depression and anxiety-related disorders. Conclusions and Relevance: This cohort study, including mostly patients with type 2 diabetes, does not show an association between use of GLP-1 receptor agonists and an increased risk of suicide death, self-harm, or incident depression and anxiety-related disorders. Suicide death among GLP-1 receptor agonist users was rare, and the upper limit of the confidence interval was compatible with an absolute risk increase of no more than 0.16 events per 1000 person-years. © 2024 Ueda P et al.
Authors : Ueda P.; Söderling J.; Wintzell V.; Svanström H.; Pazzagli L.; Eliasson B.; Melbye M.; Hviid A.; Pasternak B.
Source : American Medical Association
Article Information
| Year | 2024 |
| Type | Article |
| DOI | 10.1001/jamainternmed.2024.4369 |
| ISSN | 21686106 |
| Volume | 184 |
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