29 Oct Exploration of the Risk of Suicidality and Self-Harm With GLP-1 Receptor Agonists: A Critical Appraisal
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Exploration of the Risk of Suicidality and Self-Harm With GLP-1 Receptor Agonists: A Critical Appraisal
HC0087
Overview
What is the issue?
- Glucagon-like peptide-1 (GLP-1) receptor agonists are drugs used in the treatment of type 2 diabetes, with some products (semaglutide and liraglutide) also indicated for weight management. However, there are other GLP-1 receptor agonists used off-label for weight loss.
- Recently, there have been reports of self-harm behaviors and suicidal ideation (thoughts of suicide) in patients treated with these drugs.
What was the aim of the study?
- To review and critically appraise the available real-world evidence to evaluate the association between GLP-1 receptor agonists and the risk of suicidality and self-harm among patients with type 2 diabetes or obesity.
How was the study conducted?
- A literature search was conducted on February 22, 2024 to identify observational studies examining this association.
- The methods sections of the included studies were reviewed for various sources of bias, including important biases specific to the pharmacoepidemiologic literature such as prevalent users bias and time-related biases.
What did the study find?
- Two comparative observational studies reporting on the risk of suicidality or self-harm met the inclusion criteria.
- The first study used a primary care database from the UK and included 16,190 patients. The second study used electronic health records from patients across the US and included 105,556 patients with overweight or obesity and 55,542 patients with type 2 diabetes.
- The studies had contradictory findings, and both had methodological limitations including small sample sizes and biases related to time.
Implications
- Large, well-designed observational studies are needed to provide robust evidence on the potential association between GLP-1 receptor agonists and the risk of suicidality and self-harm.
Key messages
- The current available real-world evidence on the potential association between GLP-1 receptor agonists and the risk of suicidality and self-harm is limited, as the studies had contradictory findings and important methodological limitations.