From the Guidelines
Wegovy (semaglutide) is not contraindicated for papillary thyroid carcinoma, but it is contraindicated in patients with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2, as stated in the guidelines 1.
Key Points
- The contraindication is based on animal studies that showed an increased risk of thyroid C-cell tumors with the use of GLP-1 receptor agonists, such as semaglutide 1.
- Papillary thyroid carcinoma is a different type of thyroid cancer, and the guidelines do not specifically mention it as a contraindication for semaglutide use 1.
- However, it is essential to note that the human relevance of the animal studies is not fully determined, and the guidelines recommend caution when using semaglutide in patients with a history of thyroid cancer 1.
- The prescribing information for semaglutide should be consulted for a comprehensive discussion of safety considerations, including potential risks and contraindications 1.
Important Considerations
- Patients with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2 shouldn't use semaglutide 1.
- Semaglutide can cause other side effects, such as nausea, diarrhea, and increased heart rate, which should be monitored and managed accordingly 1.
From the Research
Contraindications of Wegovy (Semaglutide)
- Wegovy (semaglutide) is a glucagon-like peptide-1 receptor agonist (GLP-1RA) used for the treatment of type 2 diabetes and obesity.
- The association between GLP-1RAs and thyroid cancer, including papillary thyroid carcinoma (PTC), has been investigated in several studies 2, 3, 4, 5, 6.
Risk of Papillary Thyroid Carcinoma
- A meta-analysis of randomized controlled trials found no significant association between GLP-1RA treatment and papillary thyroid cancer (MH-OR 1.54 [95% CI 0.77,3.06]; P = 0.22) 2.
- A real-world study using the FDA Adverse Event Reporting System (FAERS) database detected a significant signal between GLP-1RA and papillary thyroid cancer (PRR 8.68) 3.
- A study on the Egyptian population found an association between GLP-1R gene polymorphism and expression with the risk of papillary thyroid carcinoma (PTC) 4.
- Another study suggested that GLP-1R agonists might increase the risk of thyroid C-cell pathology in rodents, but the risk in humans awaits confirmation 5.
Semaglutide and Papillary Thyroid Carcinoma
- A recent study found that semaglutide, a GLP-1RA, reprograms macrophages via the GLP-1R/PPARG/ACSL1 pathway to suppress papillary thyroid carcinoma growth, suggesting a potential therapeutic effect 6.
- However, the current evidence does not provide a clear answer to whether Wegovy (semaglutide) is contraindicated for papillary thyroid carcinoma, and further studies are needed to fully understand the relationship between GLP-1RAs and thyroid cancer.