Association between GLP-1RA use and progression of MGUS to Multiple Myeloma among diabetic patients.

IF 3.4 Q2 ONCOLOGY
Nikhil Grandhi, Lawrence Liu, Mei Wang, Theodore Thomas, Martin Schoen, Kristen Sanfilippo, Feng Gao, Graham A Colditz, Kenneth R Carson, Murali Janakiram, Su-Hsin Chang
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引用次数: 0

Abstract

Background: In patients with diabetes mellitus (DM) and monoclonal gammopathy of undetermined significance (MGUS), the impact of GLP-1 receptor agonists (GLP-1RAs) on the natural history of MGUS is unknown. We aimed to assess the association of GLP-1RA use in the progression of MGUS to multiple myeloma (MM) in patients with DM.

Methods: This is a population-based cohort study of Veterans diagnosed with MGUS from 2006-2021 with a prior diagnosis of DM. A validated natural language processing-algorithm was used to confirm MGUS and progression to MM. Gray's test was performed to detect the difference in cumulative Incidence functions (CIFs) for progression by GLP-1RA use status. The association between time-varying GLP-1RA use and progression was estimated in the 1 (exposed):2 (unexposed) matched cohort via multivariable-adjusted hazard ratio (aHR) using stratified Fine-Gray distribution hazard model with death as a competing event and stratum for the matched patient triad.

Results: Our analytic cohort included 1,097 MGUS patients who ever used GLP-1RAs, and the matched 2,194 patients who never used GLP-1RAs. Overall, 2.55% progressed in the GLP-1RA ever use group, compared to 5.01% in the GLP-1RA never use group. CIFs were significantly different between the exposed and unexposed groups (P = .02). GLP-1RA use, compared to no-use, was associated with decreased progression to MM (aHR 0.45, 95% confidence interval 0.22 to 0.93, P = .03).

Conclusions: For patients with DM and MGUS, GLP-1RA use is associated with a 55% reduction in risk of progression from MGUS to MM, compared to no use.

糖尿病患者使用 GLP-1RA 与 MGUS 进展为多发性骨髓瘤之间的关系。
背景:在糖尿病(DM)和意义未定的单克隆丙种球蛋白病(MGUS)患者中,GLP-1受体激动剂(GLP-1RA)对MGUS自然史的影响尚不清楚。我们旨在评估使用 GLP-1RA 与 DM 患者的 MGUS 进展为多发性骨髓瘤(MM)之间的关联:这是一项基于人群的队列研究,研究对象是 2006-2021 年间被诊断为 MGUS 且之前诊断为 DM 的退伍军人。研究采用了一种经过验证的自然语言处理算法来确认MGUS和MM的进展。通过格雷氏检验来检测GLP-1RA使用状况对进展的累积发生率函数(CIF)的差异。在1(暴露):2(未暴露)配对队列中,使用分层Fine-Gray分布危险度模型,以死亡作为竞争事件,通过多变量调整危险度比(aHR)估算GLP-1RA使用时变与疾病进展之间的关系:我们的分析队列包括1097名曾经使用过GLP-1RAs的MGUS患者和2194名从未使用过GLP-1RAs的匹配患者。总体而言,曾使用 GLP-1RA 组中有 2.55% 的患者病情恶化,而从未使用 GLP-1RA 组中有 5.01%的患者病情恶化。暴露组和未暴露组的 CIF 有明显差异(P = 0.02)。与不使用GLP-1RA相比,使用GLP-1RA与MM进展的减少有关(aHR为0.45,95%置信区间为0.22至0.93,P = .03):结论:与不使用GLP-1RA相比,DM和MGUS患者使用GLP-1RA可将MGUS进展为MM的风险降低55%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JNCI Cancer Spectrum
JNCI Cancer Spectrum Medicine-Oncology
CiteScore
7.70
自引率
0.00%
发文量
80
审稿时长
18 weeks
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