From the Guidelines
Having a history of papillary thyroid cancer does not automatically disqualify you from taking Ozempic (semaglutide), as the FDA warning about thyroid cancer risk with GLP-1 receptor agonists specifically relates to medullary thyroid carcinoma. The most recent and highest quality study, 1, published in 2023, indicates that semaglutide, the active ingredient in Ozempic, has a contraindication for personal or family history of medullary thyroid cancer or MEN2, but does not mention papillary thyroid cancer as a contraindication. Key considerations for using Ozempic in patients with a history of papillary thyroid cancer include:
- Monitoring thyroid function closely while on Ozempic as a precaution
- Evaluating other factors such as current thyroid status, ongoing cancer treatments, other medications, and overall health condition
- Starting with the standard dose of 0.25 mg once weekly for four weeks, then increasing to 0.5 mg weekly, with possible further increases based on response and tolerance, as recommended in 1 and 1. It is essential to discuss your complete medical history with your healthcare provider before starting Ozempic, as they will need to assess your individual situation and make an informed decision about the safety and efficacy of Ozempic for you.
From the FDA Drug Label
OZEMPIC is contraindicated in patients with: • A personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) Do not use OZEMPIC if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC), or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
The FDA drug label does not explicitly address the use of Ozempic in patients with a history of papillary thyroid cancer. However, it does mention that Ozempic may cause thyroid tumors, including cancer, and that patients should be monitored for symptoms of thyroid cancer.
- The label specifically contraindicates Ozempic in patients with a history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
- Since the label does not provide direct information on the use of Ozempic in patients with a history of papillary thyroid cancer, a conservative clinical decision would be to exercise caution and consider alternative treatment options.
- It is essential to consult with a healthcare provider to discuss the potential risks and benefits of using Ozempic in patients with a history of papillary thyroid cancer 2 2.
From the Research
Ozempic and Papillary Thyroid Cancer
- There is no direct evidence in the provided studies regarding the use of Ozempic in patients with a history of papillary thyroid cancer.
- However, study 3 investigated the association between type 2 diabetes, antihyperglycemic drug therapy, and signs of tumor invasion in papillary thyroid cancer, which may be relevant to the use of Ozempic, a medication used to treat type 2 diabetes.
- The study found that papillary thyroid cancer complicated with type 2 diabetes has a higher risk of invasive tumor growth, and that patients treated with acarbose had a lower risk of aggressive tumor growth compared to those treated with other antihyperglycemic drugs.
- It is essential to note that Ozempic (semaglutide) is a glucagon-like peptide-1 receptor agonist, which is a different class of medication than acarbose, and its effects on papillary thyroid cancer are not directly addressed in the provided studies.
- Therefore, the decision to use Ozempic in patients with a history of papillary thyroid cancer should be made on a case-by-case basis, taking into account the individual patient's medical history, current health status, and potential risks and benefits, as discussed with a healthcare provider 3.